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New Hampshire rates for HCPCS L5250

Hip Disarticulation Canadian Type; Molded Socket Hip Joint Single Axis Constant Friction Knee Shin Sach Foot

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,765.37 / $3,765.37 / $4,518.43
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,781.05 / $2,921.84 / $3,765.37
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,687.26 / $6,687.26 / $7,927.08
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,804.46 / $3,804.46 / $3,974.04
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,366.38 / $4,366.38 / $4,366.38
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,187.46 / $3,187.46 / $4,497.37
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5,414.38 / $5,414.38 / $16,711.48
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,612.21 / $4,675.34 / $5,414.38
Well Sense
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5,008.54 / $5,509.39 / $7,011.96