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New Hampshire rates for HCPCS L5200

Above Knee Molded Socket Single Axis Constant Friction Knee Shin Sach Foot

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,831.07 / $2,831.07 / $3,397.28
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,783.36 / $2,196.84 / $2,831.07
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,027.93 / $5,027.93 / $5,960.12
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,396.26 / $2,396.26 / $2,530.21
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,728.17 / $2,728.17 / $2,728.17
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,991.56 / $1,991.56 / $2,728.17
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,070.90 / $4,070.90 / $12,564.83
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,672.26 / $2,508.38 / $3,068.55
Well Sense
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,765.76 / $4,142.34 / $5,272.06