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New Hampshire rates for HCPCS L5160

Knee disarticulation (or through knee), molded socket, bent knee configuration, external knee joints, shin, SACH foot

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,846.90 / $2,846.90 / $3,416.28
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,047.29 / $2,209.13 / $2,846.90
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,056.05 / $5,056.05 / $5,993.44
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,800.76 / $2,800.76 / $2,925.52
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,670.30 / $3,670.30 / $3,670.30
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,679.32 / $2,679.32 / $3,716.14
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,093.67 / $4,093.67 / $12,635.11
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,681.61 / $2,522.41 / $4,028.53
Well Sense
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,786.82 / $4,165.50 / $5,301.55