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New Hampshire rates for HCPCS L5570

Preparatory, above knee (AK), knee disarticulation, ischial level socket, nonalignable system, pylon, no cover, SACH foot, thermoplastic or equal, direct formed

Facilitymedian $2,884 · 10th–90th $1,585–$3,4670%20%40%10th90th$2,884Professionalmedian $1,905 · 10th–90th $1,230–$2,6920%20%10th90th$1,905$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
$1,584.89 / $1,584.89 / $1,905.46
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,096.48 / $1,584.89 / $2,290.87
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,884.03 / $3,090.30 / $3,548.13
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,479.11 / $1,479.11 / $1,479.11
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,778.28 / $1,778.28 / $2,089.30
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,288.25 / $1,288.25 / $1,778.28
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,511.89 / $2,511.89 / $4,570.88
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$741.31 / $1,584.89 / $1,819.70
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,122.02 / $1,862.09 / $2,511.89
Well Sense
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,754.23 / $2,754.23 / $4,073.80