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New Hampshire rates for HCPCS L5420

Immediate postsurgical or early fitting, application of initial rigid dressing, including fitting, alignment and suspension and one cast change above knee (AK) or knee disarticulation

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,027.25 / $1,027.25 / $1,232.70
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$797.13 / $814.73 / $1,094.63
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,824.39 / $1,824.39 / $2,162.63
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,114.58 / $1,114.58 / $1,164.22
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,573.58 / $1,573.58 / $1,573.58
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,148.71 / $1,148.71 / $1,573.58
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,477.13 / $1,477.13 / $4,559.16
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,261.08 / $1,261.08 / $1,261.08
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$606.78 / $910.17 / $1,369.67
Well Sense
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,366.40 / $1,503.04 / $1,912.96