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Maine rates for HCPCS L5646

Addition to lower extremity, below knee (BK), air, fluid, gel or equal, cushion socket

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$354.81 / $426.58 / $1,348.96
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$870.96 / $1,047.13 / $1,174.90
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$398.11 / $398.11 / $891.25
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$407.38 / $407.38 / $645.65
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$302.00 / $302.00 / $407.38
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$758.58 / $758.58 / $912.01
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$371.54 / $436.52 / $1,348.96
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$208.93 / $331.13 / $436.52
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$288.40 / $489.78 / $758.58