go back

Maine rates for HCPCS L5920

Addition Endoskeletal System Above Knee Or Hip Disarticulation Alignable System

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$371.00 / $571.88 / $571.88
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$755.21 / $978.44 / $1,813.72
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$386.54 / $406.47 / $637.48
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$397.94 / $397.94 / $624.08
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$290.50 / $290.50 / $397.94
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$687.50 / $687.50 / $687.50
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$478.11 / $571.88 / $571.88
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$282.41 / $489.58 / $974.18