go back

Maine rates for HCPCS L5639

Addition To Lower Extremity Below Knee Wood Socket

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$783.96 / $1,208.42 / $1,208.42
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,595.81 / $2,067.51 / $3,832.52
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$822.12 / $858.74 / $1,347.04
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$870.50 / $870.50 / $1,318.76
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$635.47 / $635.47 / $870.50
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,452.72 / $1,452.72 / $1,452.72
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,010.28 / $1,208.42 / $1,208.42
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$596.75 / $895.13 / $2,058.52