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Maine rates for HCPCS L5631

Addition To Lower Extremity Above Knee Or Knee Disarticulation Acrylic Socket

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$307.22 / $473.57 / $473.57
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$625.38 / $810.24 / $1,501.93
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$319.89 / $336.53 / $527.89
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$329.53 / $329.53 / $516.79
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$240.56 / $240.56 / $329.53
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$569.30 / $569.30 / $569.30
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$395.92 / $473.57 / $473.57
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$233.86 / $396.41 / $806.72