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Maine rates for HCPCS L5703

Ankle, Symes, molded to patient model, socket without solid ankle cushion heel (SACH) foot, replacement only

Facilitymedian $3,311 · 10th–90th $2,138–$3,8020%20%10th90th$3,311Professionalmedian $1,698 · 10th–90th $1,230–$2,8840%20%10th90th$1,698$1.0K$2.0K$5.0K$10.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,202.26 / $1,513.56 / $4,365.16
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,818.38 / $3,388.44 / $3,801.89
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,513.56 / $1,513.56 / $2,884.03
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,137.96 / $2,137.96 / $2,137.96
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,548.82 / $1,548.82 / $2,137.96
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,454.71 / $2,454.71 / $2,951.21
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,202.26 / $1,698.24 / $1,905.46
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$794.33 / $1,659.59 / $1,659.59
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,047.13 / $2,454.71 / $2,630.27