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New Hampshire rates for HCPCS L5570

Preparatory Above Knee - Knee Disarticulation Ischial Level Socket Non-Alignable System Pylon No Cover Sach Foot Thermoplastic Or Equal Direct Formed

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,602.54 / $1,602.54 / $1,923.05
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,083.06 / $1,243.53 / $1,602.54
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,846.09 / $2,846.09 / $3,373.76
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,481.65 / $1,481.65 / $1,547.65
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,769.38 / $1,769.38 / $1,769.38
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,291.65 / $1,291.65 / $1,822.46
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,304.35 / $2,304.35 / $7,112.38
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$946.59 / $1,419.88 / $1,863.56
Well Sense
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,131.63 / $2,344.79 / $2,984.28