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New Hampshire rates for HCPCS L5580

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

Facilitymedian $3,020 · 10th–90th $1,660–$3,5480%10%20%10th90th$3,020Professionalmedian $1,995 · 10th–90th $1,349–$2,7540%20%10th90th$1,995$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
$1,659.59 / $1,659.59 / $1,995.26
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,258.93 / $1,659.59 / $2,630.27
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,019.95 / $3,235.94 / $3,630.78
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,819.70 / $1,819.70 / $1,862.09
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,778.28 / $1,778.28 / $2,187.76
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
$2,570.40 / $2,570.40 / $4,786.30
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$870.96 / $1,862.09 / $2,137.96
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,318.26 / $2,137.96 / $2,570.40
Well Sense
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,884.03 / $2,884.03 / $4,265.80