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Maine rates for HCPCS L5655

Addition to lower extremity, socket insert, below knee (BK) (Kemblo, Pelite, Aliplast, Plastazote or equal)

Facilitymedian $398 · 10th–90th $214–$4790%20%10th90th$398Professionalmedian $209 · 10th–90th $162–$3890%10%20%10th90th$209$100.0$200.0$500.0$1.0K$2.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$158.49 / $181.97 / $575.44
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$371.54 / $446.68 / $512.86
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$199.53 / $199.53 / $389.05
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$218.78 / $218.78 / $275.42
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$162.18 / $162.18 / $218.78
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$331.13 / $331.13 / $398.11
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$158.49 / $194.98 / $257.04
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$102.33 / $208.93 / $213.80
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$131.83 / $323.59 / $331.13