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New Hampshire rates for HCPCS L5622

Addition to lower extremity, test socket, knee disarticulation

Facilitymedian $550 · 10th–90th $302–$6610%10%20%10th90th$550Professionalmedian $363 · 10th–90th $234–$5130%20%10th90th$363$200.0$500.0$1.0K$2.0K

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
$302.00 / $302.00 / $363.08
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$229.09 / $302.00 / $426.58
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$549.54 / $588.84 / $676.08
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$263.03 / $263.03 / $263.03
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$275.42 / $275.42 / $398.11
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$199.53 / $199.53 / $275.42
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$478.63 / $478.63 / $870.96
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$134.90 / $288.40 / $323.59
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$213.80 / $331.13 / $478.63
Well Sense
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$524.81 / $524.81 / $776.25