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Maine rates for HCPCS L5988

Addition To Lower Limb Prosthesis Vertical Shock Reducing Pylon Feature

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,028.46 / $1,585.32 / $1,585.32
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,093.52 / $2,712.35 / $5,027.84
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,374.81 / $1,374.81 / $1,767.17
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,346.19 / $1,346.19 / $1,730.06
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$982.72 / $982.72 / $1,346.19
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,905.81 / $1,905.81 / $1,905.81
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,325.38 / $1,585.32 / $1,585.32
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$782.88 / $1,417.54 / $2,700.55