go back

Maine rates for HCPCS L5632

Addition to lower extremity, Symes type, PTB brim design socket

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$132.72 / $204.57 / $204.57
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$270.16 / $350.01 / $648.80
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$170.07 / $170.07 / $228.04
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$166.52 / $166.52 / $223.24
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$121.56 / $121.56 / $166.52
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$245.92 / $245.92 / $245.92
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$171.03 / $204.57 / $204.57
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$102.44 / $200.33 / $348.48