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Maine rates for HCPCS L5671

Addition to lower extremity, below knee (BK)/above knee (AK) suspension locking mechanism (shuttle, lanyard, or equal), excludes socket insert

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$281.84 / $380.19 / $912.01
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$588.84 / $707.95 / $812.83
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$416.87 / $416.87 / $602.56
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$380.19 / $380.19 / $436.52
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$275.42 / $275.42 / $380.19
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$524.81 / $524.81 / $630.96
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$288.40 / $398.11 / $933.25
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$190.55 / $398.11 / $398.11
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$234.42 / $446.68 / $602.56