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Maine rates for HCPCS L5940

Addition, endoskeletal system, below knee (BK), ultra-light material (titanium, carbon fiber or equal)

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$263.05 / $405.49 / $405.49
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$535.46 / $693.74 / $1,285.98
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$365.89 / $384.19 / $451.99
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$382.03 / $382.03 / $442.50
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$278.88 / $278.88 / $382.03
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$487.46 / $487.46 / $487.46
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$338.99 / $405.49 / $405.49
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$200.24 / $300.36 / $690.72