go back

Maine rates for HCPCS L5856

Addition to lower extremity prosthesis, endoskeletal knee-shin system, microprocessor control feature, swing and stance phase, includes electronic sensor(s), any type

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12,499.54 / $19,267.39 / $19,267.39
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$25,443.81 / $32,964.81 / $61,106.35
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16,544.62 / $16,544.62 / $21,477.48
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$16,200.25 / $16,200.25 / $16,200.25
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$11,826.18 / $11,826.18 / $16,200.25
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$23,162.50 / $23,162.50 / $23,162.50
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16,108.11 / $19,267.39 / $19,267.39
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9,514.76 / $14,272.14 / $32,821.50