go back

New Hampshire rates for HCPCS L5613

Addition to lower extremity, endoskeletal system, above knee (AK), knee disarticulation, four-bar linkage, with hydraulic swing phase control

Facilitymedian $3,981 · 10th–90th $2,188–$4,7860%20%40%10th90th$3,981Professionalmedian $2,455 · 10th–90th $1,479–$3,7150%20%10th90th$2,455$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
$2,187.76 / $2,187.76 / $2,630.27
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,288.25 / $1,905.46 / $2,630.27
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,981.07 / $4,265.80 / $4,897.79
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,778.28 / $1,778.28 / $1,778.28
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,905.46 / $1,905.46 / $2,884.03
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,380.38 / $1,380.38 / $1,905.46
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,467.37 / $3,467.37 / $6,309.57
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$912.01 / $1,949.84 / $2,187.76
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,479.11 / $2,238.72 / $3,467.37
Well Sense
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,801.89 / $3,801.89 / $5,623.41