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New Hampshire rates for HCPCS L4030

Replace quadrilateral socket brim, custom fitted

Facilitymedian $575 · 10th–90th $324–$6920%20%40%10th90th$575Professionalmedian $457 · 10th–90th $275–$6460%20%10th90th$457$200.0$500.0$1.0K$2.0K

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
$323.59 / $323.59 / $380.19
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$245.47 / $323.59 / $645.65
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$575.44 / $616.60 / $707.95
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$346.74 / $346.74 / $346.74
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$416.87 / $478.63 / $478.63
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$346.74 / $346.74 / $478.63
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$501.19 / $501.19 / $912.01
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$173.78 / $295.12 / $398.11
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$218.78 / $371.54 / $501.19
Well Sense
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$549.54 / $549.54 / $812.83