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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
$1,071.52 / $1,230.27 / $3,630.78
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,344.23 / $2,818.38 / $3,162.28
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,445.44 / $1,445.44 / $2,398.83
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,348.96 / $1,348.96 / $1,737.80
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$977.24 / $977.24 / $1,348.96
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,041.74 / $2,041.74 / $2,454.71
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,071.52 / $1,479.11 / $3,630.78
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$691.83 / $1,412.54 / $1,412.54
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$851.14 / $1,621.81 / $2,290.87