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New Hampshire rates for HCPCS L5000

Partial foot, shoe insert with longitudinal arch, toe filler

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$338.84 / $338.84 / $407.38
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$263.03 / $338.84 / $512.86
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$616.60 / $660.69 / $758.58
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$380.19 / $380.19 / $389.05
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$446.68 / $457.09 / $457.09
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$338.84 / $338.84 / $457.09
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$524.81 / $524.81 / $933.25
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$186.21 / $398.11 / $457.09
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$234.42 / $323.59 / $524.81
Well Sense
Facility/Professional
Facility
Modifier
Low / Median / High Price
$537.03 / $537.03 / $870.96