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New Hampshire rates for HCPCS L3995

Addition to upper extremity orthosis, sock, fracture or equal, each

Facilitymedian $49 · 10th–90th $27–$580%10%20%10th90th$49Professionalmedian $30 · 10th–90th $20–$420%20%10th90th$30$10.0$20.0$50.0$100.0$200.0

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$26.92 / $26.92 / $32.36
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$18.20 / $22.91 / $34.67
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$48.98 / $52.48 / $60.26
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$22.39 / $22.39 / $22.91
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$30.20 / $30.20 / $35.48
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$21.88 / $21.88 / $30.20
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$41.69 / $41.69 / $77.62
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$10.96 / $18.62 / $20.89
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$16.22 / $27.54 / $41.69
Well Sense
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$46.77 / $46.77 / $60.26