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Maine rates for HCPCS L5676

Additions To Lower Extremity Below Knee Knee Joints Single Axis Pair

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$248.92 / $383.71 / $383.71
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$506.72 / $656.50 / $1,216.94
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$263.39 / $277.55 / $427.72
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$271.77 / $271.77 / $418.74
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$198.39 / $198.39 / $271.77
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$461.28 / $461.28 / $461.28
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$320.79 / $383.71 / $383.71
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$189.49 / $284.23 / $653.63