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New Hampshire rates for HCPCS L1907

Afo Orthosis Supramalleolar With Straps With Orwithout Interface/Pads Custom Fabricated (Revised01/01/14)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$372.59 / $372.59 / $447.11
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$272.33 / $289.12 / $401.65
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$661.72 / $661.72 / $784.40
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$386.49 / $396.47 / $396.47
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$419.48 / $419.48 / $419.48
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$306.22 / $306.22 / $486.35
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$535.76 / $535.76 / $1,653.62
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$220.08 / $330.12 / $391.98
Well Sense
Facility/Professional
Professional
Modifier
Low / Median / High Price
$495.60 / $545.16 / $693.84