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Maine rates for HCPCS L5964

Addition, endoskeletal system, above knee (AK), flexible protective outer surface covering system

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$558.46 / $860.84 / $860.84
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,136.80 / $1,472.82 / $2,730.15
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$682.97 / $717.31 / $959.58
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$702.38 / $702.38 / $939.43
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$512.74 / $512.74 / $702.38
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,034.85 / $1,034.85 / $1,034.85
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$719.69 / $860.84 / $860.84
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$425.10 / $739.83 / $1,466.41