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Maine rates for HCPCS L5822

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

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,190.71 / $1,835.41 / $1,835.41
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,423.78 / $3,140.24 / $5,821.01
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,242.91 / $1,304.29 / $2,045.95
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,367.82 / $1,367.82 / $2,002.99
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$998.51 / $998.51 / $1,367.82
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,206.46 / $2,206.46 / $2,206.46
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,534.46 / $1,835.41 / $1,835.41
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,347.44 / $1,347.44 / $1,347.44
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$906.38 / $1,359.56 / $3,126.58