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Maine rates for HCPCS L5628

Addition to lower extremity, test socket, hemipelvectomy

Facilitymedian $692 · 10th–90th $380–$8320%20%10th90th$692Professionalmedian $380 · 10th–90th $288–$6760%10%10th90th$380$200.0$500.0$1.0K$2.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$275.42 / $346.74 / $1,000.00
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$645.65 / $776.25 / $891.25
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$354.81 / $354.81 / $676.08
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$457.09 / $501.19 / $501.19
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$363.08 / $363.08 / $501.19
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$575.44 / $575.44 / $691.83
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$275.42 / $380.19 / $446.68
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$186.21 / $288.40 / $380.19
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$239.88 / $562.34 / $616.60