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Maine rates for HCPCS L5961

Addition, endoskeletal system, polycentric hip joint, pneumatic or hydraulic control, rotation control, with or without flexion and/or extension control

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,454.71 / $3,090.30 / $3,715.35
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,370.32 / $6,456.54 / $7,413.10
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,548.13 / $3,548.13 / $3,548.13
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,715.35 / $3,715.35 / $3,715.35
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,691.53 / $2,691.53 / $3,715.35
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,786.30 / $4,786.30 / $5,754.40
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,691.53 / $3,311.31 / $5,370.32
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,621.81 / $3,388.44 / $3,388.44
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,995.26 / $3,981.07 / $5,370.32