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New Hampshire rates for HCPCS L1630

Hip orthosis (HO), abduction control of hip joints, semi-flexible (Von Rosen type), custom fabricated

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$144.54 / $144.54 / $173.78
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$83.18 / $128.82 / $181.97
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$257.04 / $275.42 / $316.23
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$117.49 / $117.49 / $117.49
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$120.23 / $120.23 / $186.21
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$87.10 / $87.10 / $120.23
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$223.87 / $223.87 / $389.05
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$58.88 / $95.50 / $125.89
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$85.11 / $125.89 / $223.87
Well Sense
Facility/Professional
Facility
Modifier
Low / Median / High Price
$229.09 / $229.09 / $363.08