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New Hampshire rates for HCPCS L1950

Ankle Foot Orthosis Spiral (Institute Of Rehabilitative Medicine Type) Plastic Custom-Fabricated. (Rvsd 1/1/04)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$604.96 / $604.96 / $725.95
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$363.48 / $469.44 / $634.05
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,074.42 / $1,074.42 / $1,273.61
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$505.33 / $505.33 / $535.48
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$524.34 / $524.34 / $524.34
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$382.77 / $382.77 / $558.97
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$869.91 / $869.91 / $2,684.98
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$357.34 / $574.29 / $869.91
Well Sense
Facility/Professional
Professional
Modifier
Low / Median / High Price
$804.70 / $885.17 / $1,126.58