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New Hampshire rates for HCPCS L5301

Below knee (BK), molded socket, shin, SACH foot, endoskeletal system

Facilitymedian $3,020 · 10th–90th $1,660–$3,5480%10%20%10th90th$3,020Professionalmedian $2,042 · 10th–90th $1,288–$2,8180%20%10th90th$2,042$1.0K$2.0K$5.0K$10.0K

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
$1,659.59 / $1,659.59 / $1,995.26
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,202.26 / $1,659.59 / $2,818.38
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,019.95 / $3,235.94 / $3,630.78
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,995.26 / $1,995.26 / $2,041.74
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,737.80 / $1,737.80 / $2,187.76
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,258.93 / $1,258.93 / $1,737.80
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,570.40 / $2,570.40 / $4,786.30
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$851.14 / $1,905.46 / $2,089.30
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,258.93 / $2,089.30 / $2,570.40
Well Sense
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,818.38 / $2,818.38 / $4,168.69