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New Hampshire rates for HCPCS L5624

Addition to lower extremity, test socket, above knee (AK)

Facilitymedian $589 · 10th–90th $331–$7080%20%10th90th$589Professionalmedian $389 · 10th–90th $229–$5500%20%10th90th$389$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
$331.13 / $331.13 / $389.05
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$218.78 / $316.23 / $389.05
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$588.84 / $630.96 / $724.44
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$263.03 / $263.03 / $275.42
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$309.03 / $309.03 / $426.58
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$229.09 / $229.09 / $309.03
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$512.86 / $512.86 / $933.25
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$134.90 / $288.40 / $331.13
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$218.78 / $331.13 / $512.86
Well Sense
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$562.34 / $562.34 / $831.76