go back

New Hampshire rates for HCPCS L2010

Knee-ankle-foot orthosis (KAFO), single upright, free ankle, solid stirrup, thigh and calf bands/cuffs (single bar 'AK' orthosis), without knee joint, custom fabricated

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$660.69 / $660.69 / $794.33
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$512.86 / $602.56 / $1,202.26
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,202.26 / $1,288.25 / $1,479.11
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$630.96 / $630.96 / $630.96
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$741.31 / $741.31 / $870.96
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$537.03 / $537.03 / $741.31
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,023.29 / $1,023.29 / $1,819.70
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$323.59 / $537.03 / $933.25
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$389.05 / $588.84 / $1,023.29
Well Sense
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,047.13 / $1,047.13 / $1,698.24