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New Hampshire rates for HCPCS L5230

Above knee (AK), for proximal femoral focal deficiency, constant friction knee, shin, SACH foot

Facilitymedian $4,898 · 10th–90th $2,692–$5,7540%10%20%10th90th$4,898Professionalmedian $3,236 · 10th–90th $2,089–$5,0120%20%10th90th$3,236$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
$2,691.53 / $2,691.53 / $3,235.94
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,995.26 / $2,691.53 / $5,011.87
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4,897.79 / $5,248.07 / $5,888.44
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,754.23 / $2,754.23 / $2,884.03
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,884.03 / $2,884.03 / $3,548.13
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,089.30 / $2,089.30 / $2,884.03
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4,168.69 / $4,168.69 / $7,762.47
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,412.54 / $3,090.30 / $3,467.37
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,089.30 / $3,467.37 / $4,168.69
Well Sense
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4,677.35 / $4,677.35 / $6,918.31