go back

New Hampshire rates for HCPCS L5505

Initial Above Knee - Knee Disarticulation Ischial Level Socket Non-Alignable System Pylon No Cover Sach Foot Plaster Socket Direct Formed

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,383.75 / $1,383.75 / $1,660.50
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$932.26 / $1,073.75 / $1,383.75
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,457.52 / $2,457.52 / $2,913.14
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,275.38 / $1,275.38 / $1,332.19
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,620.00 / $1,620.00 / $1,620.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,182.59 / $1,182.59 / $1,668.60
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,989.74 / $1,989.74 / $6,141.33
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$817.35 / $1,226.03 / $1,604.89
Well Sense
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,840.60 / $2,024.66 / $2,576.84