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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
$2,389.30 / $3,682.99 / $3,682.99
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,863.63 / $6,301.28 / $11,680.59
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,171.15 / $3,327.75 / $4,105.43
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,745.37 / $3,745.37 / $4,019.22
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,734.12 / $2,734.12 / $3,745.37
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,427.55 / $4,427.55 / $4,427.55
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,079.08 / $3,682.99 / $3,682.99
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,818.76 / $2,728.14 / $6,273.86