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Maine rates for HCPCS L5658

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

Facilitymedian $525 · 10th–90th $288–$6460%20%10th90th$525Professionalmedian $269 · 10th–90th $204–$5130%10%20%10th90th$269$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
$194.98 / $263.03 / $776.25
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$501.19 / $602.56 / $691.83
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$269.15 / $269.15 / $512.86
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$354.81 / $363.08 / $371.54
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$269.15 / $269.15 / $363.08
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$446.68 / $446.68 / $537.03
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$194.98 / $269.15 / $338.84
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$138.04 / $223.87 / $288.40
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$181.97 / $436.52 / $457.09