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Maine rates for HCPCS L5840

Addition, endoskeletal knee-shin system, four-bar linkage or multiaxial, pneumatic swing phase control

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,942.80 / $2,994.72 / $2,994.72
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,954.72 / $5,123.70 / $9,497.71
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,516.48 / $2,596.02 / $3,338.23
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,117.24 / $3,364.97 / $3,364.97
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,456.42 / $2,456.42 / $3,364.97
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,600.14 / $3,600.14 / $3,600.14
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,503.67 / $2,994.72 / $2,994.72
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,478.88 / $2,676.50 / $5,101.43