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New Hampshire rates for HCPCS L5626

Addition to lower extremity, test socket, hip disarticulation

Facilitymedian $708 · 10th–90th $389–$8320%20%40%10th90th$708Professionalmedian $468 · 10th–90th $302–$6310%20%10th90th$468$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
$389.05 / $389.05 / $467.74
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$251.19 / $363.08 / $549.54
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$707.95 / $758.58 / $870.96
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$346.74 / $346.74 / $354.81
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$489.78 / $489.78 / $512.86
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$363.08 / $363.08 / $489.78
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$602.56 / $602.56 / $1,122.02
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$177.83 / $380.19 / $426.58
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$269.15 / $436.52 / $602.56
Well Sense
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$676.08 / $676.08 / $1,000.00