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New Hampshire rates for HCPCS L2034

Knee Ankle Foot Orthosis Full Plastic Single Upright With Or Without Free Motion Knee Medial Lateral Rotation Control With Or Without Free Motion Ankle Custom Fabricated

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,324.95 / $1,324.95 / $1,589.94
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$986.10 / $1,028.13 / $1,428.28
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,353.08 / $2,353.08 / $2,789.34
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,327.04 / $1,327.04 / $1,407.46
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,618.14 / $1,618.14 / $1,618.14
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,181.24 / $1,181.24 / $1,618.14
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,905.19 / $1,905.19 / $5,880.37
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$782.62 / $1,173.93 / $1,393.90
Well Sense
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,762.39 / $1,938.63 / $2,467.35