go back

Maine rates for HCPCS L5636

Addition to lower extremity, Symes type, medial opening socket

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$134.90 / $199.53 / $630.96
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$398.11 / $478.63 / $549.54
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$186.21 / $186.21 / $416.87
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$194.98 / $194.98 / $302.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$144.54 / $144.54 / $194.98
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$354.81 / $354.81 / $426.58
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$144.54 / $257.04 / $630.96
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$97.72 / $151.36 / $199.53
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$134.90 / $229.09 / $354.81