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Maine rates for HCPCS L5722

Addition, exoskeletal knee-shin system, single axis, pneumatic swing, friction stance phase control

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$517.46 / $797.64 / $797.64
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,053.33 / $1,364.69 / $2,529.71
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$659.00 / $691.54 / $889.14
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$830.28 / $875.29 / $875.29
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$638.96 / $638.96 / $875.29
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$958.89 / $958.89 / $958.89
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$666.86 / $797.64 / $797.64
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$393.90 / $590.84 / $1,358.77