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New Hampshire rates for HCPCS L1951

Ankle foot orthosis (AFO), spiral, (Institute of Rehabilitative Medicine-type), plastic or other material, prefabricated item that has been trimmed, bent, molded, assembled, or otherwise customized to fit a specific patient by an individual with expertise

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$556.10 / $556.10 / $667.32
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$395.05 / $431.52 / $556.10
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$987.62 / $987.62 / $1,170.72
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$544.83 / $544.83 / $576.85
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$710.11 / $710.11 / $710.11
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$518.38 / $518.38 / $710.11
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$799.63 / $799.63 / $2,468.06
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$328.48 / $492.71 / $585.04
Well Sense
Facility/Professional
Professional
Modifier
Low / Median / High Price
$645.27 / $709.80 / $903.38