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New Hampshire rates for HCPCS L5020

Partial foot, molded socket, tibial tubercle height, with toe filler

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,408.12 / $1,408.12 / $1,689.74
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,062.21 / $1,092.67 / $1,684.29
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,500.80 / $2,500.80 / $2,964.45
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,517.87 / $1,556.88 / $1,556.88
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,486.28 / $1,486.28 / $1,486.28
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,084.98 / $1,084.98 / $1,584.44
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,024.79 / $2,024.79 / $6,249.51
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,428.89 / $1,428.89 / $1,428.89
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$831.75 / $1,247.61 / $1,787.52
Well Sense
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,873.02 / $2,060.32 / $2,622.23