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New Hampshire rates for HCPCS L5200

Above knee (AK), molded socket, single axis constant friction knee, shin, SACH foot

Facilitymedian $5,129 · 10th–90th $2,818–$6,0260%20%40%10th90th$5,129Professionalmedian $3,388 · 10th–90th $1,995–$4,5710%20%10th90th$3,388$2.0K$5.0K$10.0K$20.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,818.38 / $2,818.38 / $3,388.44
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,737.80 / $2,511.89 / $4,073.80
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5,128.61 / $5,495.41 / $6,309.57
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,398.83 / $2,398.83 / $2,454.71
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,754.23 / $2,754.23 / $3,715.35
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,995.26 / $1,995.26 / $2,754.23
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4,365.16 / $4,365.16 / $8,128.31
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,230.27 / $2,630.27 / $2,951.21
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,949.84 / $3,019.95 / $4,365.16
Well Sense
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4,897.79 / $4,897.79 / $7,244.36