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New Hampshire rates for HCPCS L1755

Legg Perthes orthosis, (Patten bottom type), custom fabricated

Facilitymedian $2,399 · 10th–90th $1,349–$2,8840%10%20%10th90th$2,399Professionalmedian $1,445 · 10th–90th $1,000–$2,2390%20%10th90th$1,445$1.0K$2.0K$5.0K$10.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,348.96 / $1,348.96 / $1,621.81
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$794.33 / $1,148.15 / $1,621.81
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,398.83 / $2,570.40 / $2,951.21
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,096.48 / $1,096.48 / $1,096.48
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,380.38 / $1,380.38 / $1,737.80
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,023.29 / $1,023.29 / $1,380.38
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,089.30 / $2,089.30 / $3,801.89
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$549.54 / $933.25 / $1,174.90
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$812.83 / $1,348.96 / $2,089.30
Well Sense
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,290.87 / $2,290.87 / $3,388.44