go back

Maine rates for HCPCS L5670

Addition to lower extremity, below knee (BK), molded supracondylar suspension (PTS or similar)

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$151.13 / $232.98 / $232.98
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$307.67 / $398.62 / $738.91
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$197.18 / $207.91 / $259.70
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$203.51 / $203.51 / $254.24
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$148.56 / $148.56 / $203.51
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$280.08 / $280.08 / $280.08
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$194.78 / $232.98 / $232.98
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$115.05 / $244.81 / $478.98