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Maine rates for HCPCS L5966

Addition, endoskeletal system, hip disarticulation, flexible protective outer surface covering system

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$719.39 / $1,108.90 / $1,108.90
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,464.38 / $1,897.24 / $3,516.88
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$871.01 / $914.02 / $1,236.08
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$895.00 / $895.00 / $1,210.13
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$653.35 / $653.35 / $895.00
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,333.07 / $1,333.07 / $1,333.07
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$927.07 / $1,108.90 / $1,108.90
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$547.60 / $821.41 / $1,888.99