go back

Maine rates for HCPCS L5668

Addition to lower extremity, below knee (BK), molded distal cushion

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.26 / $72.44 / $229.09
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$147.91 / $177.83 / $199.53
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$81.28 / $81.28 / $151.36
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$89.13 / $89.13 / $109.65
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$64.57 / $64.57 / $89.13
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$128.82 / $128.82 / $154.88
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$64.57 / $81.28 / $229.09
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$38.90 / $79.43 / $81.28
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$48.98 / $91.20 / $128.82