go back

New Hampshire rates for HCPCS L4030

Replace quadrilateral socket brim, custom fitted

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$320.27 / $320.27 / $384.32
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$234.09 / $303.36 / $330.04
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$568.79 / $568.79 / $674.26
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$346.43 / $346.43 / $362.98
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$477.88 / $477.88 / $477.88
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$348.85 / $348.85 / $477.88
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$460.52 / $460.52 / $1,421.40
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$213.52 / $283.76 / $478.09
Well Sense
Facility/Professional
Professional
Modifier
Low / Median / High Price
$426.01 / $468.61 / $596.41