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Maine rates for HCPCS L5702

Replacement, socket, hip disarticulation, including hip joint, molded to patient model

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,344.23 / $3,162.28 / $8,317.64
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,370.32 / $6,456.54 / $7,413.10
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,162.28 / $3,162.28 / $5,623.41
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,715.35 / $3,715.35 / $3,981.07
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,754.23 / $2,754.23 / $3,715.35
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,786.30 / $4,786.30 / $5,754.40
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,398.83 / $3,311.31 / $8,317.64
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,659.59 / $3,467.37 / $3,467.37
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,041.74 / $3,890.45 / $5,495.41