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Maine rates for HCPCS L5716

Addition Exoskeletal Knee-Shin System Polycentric Mechanical Stance Phase Lock

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$481.52 / $707.78 / $707.78
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$934.67 / $1,210.95 / $2,244.71
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$534.42 / $558.24 / $788.97
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$673.11 / $673.11 / $772.41
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$491.37 / $491.37 / $673.11
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$850.86 / $850.86 / $850.86
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$591.73 / $707.78 / $707.78
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$349.52 / $575.70 / $1,205.69