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New Hampshire rates for HCPCS L5301

Below Knee, Molded Socket, Shin, Sach Foot, Endoskeletal System

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,657.79 / $1,657.79 / $1,989.35
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,230.67 / $1,286.42 / $1,982.94
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,208.17 / $2,208.17 / $2,208.17
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,944.24 / $2,944.24 / $3,490.10
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,758.58 / $1,972.92 / $1,972.92
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,721.98 / $1,721.98 / $1,721.98
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,257.05 / $1,257.05 / $2,019.28
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,383.82 / $2,383.82 / $7,357.66
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$979.23 / $1,468.85 / $2,068.92
Well Sense
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,205.14 / $2,425.65 / $3,087.20