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New Hampshire rates for HCPCS L5000

Partial Foot Shoe Insert With Longitudinal Arch Toe Filler (Special Coverage Instructions Apply. See Mcm: 2323)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$341.46 / $341.46 / $409.75
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$264.97 / $298.74 / $408.43
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$606.42 / $606.42 / $718.86
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$379.58 / $379.58 / $386.99
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$459.90 / $459.90 / $459.90
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$335.73 / $335.73 / $459.90
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$491.01 / $491.01 / $1,515.50
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$201.70 / $302.54 / $455.74
Well Sense
Facility/Professional
Professional
Modifier
Low / Median / High Price
$454.20 / $499.62 / $635.88