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Maine rates for HCPCS L5979

All lower extremity prostheses, multiaxial ankle, dynamic response foot, one-piece system

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,242.08 / $1,914.63 / $1,914.63
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,528.40 / $3,275.77 / $6,072.24
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,660.84 / $1,747.65 / $2,134.25
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,711.28 / $1,711.28 / $2,089.44
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,249.23 / $1,249.23 / $1,711.28
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,301.69 / $2,301.69 / $2,301.69
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,600.69 / $1,914.63 / $1,914.63
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,069.79 / $2,277.15 / $3,149.05