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Maine rates for HCPCS L5640

Addition to lower extremity, knee disarticulation, leather socket

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$362.90 / $516.89 / $516.89
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$682.59 / $884.36 / $1,639.32
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$468.88 / $489.76 / $576.19
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$538.04 / $572.20 / $572.20
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$417.71 / $417.71 / $572.20
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$621.39 / $621.39 / $621.39
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$432.14 / $516.89 / $516.89
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$255.26 / $505.00 / $880.51