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Maine rates for HCPCS L5984

All Endoskeletal Lower Extremity Prostheses Axial Rotation Unit With Or Without Adjustability (Rvsd 1/1/04)

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$363.03 / $559.58 / $559.58
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$738.95 / $957.38 / $1,774.67
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$414.81 / $436.33 / $623.78
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$427.25 / $427.25 / $610.69
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$311.89 / $311.89 / $427.25
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$672.71 / $672.71 / $672.71
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$467.84 / $559.58 / $559.58
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$276.33 / $513.95 / $953.24