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New Hampshire rates for HCPCS L5628

Addition to lower extremity, test socket, hemipelvectomy

Facilitymedian $676 · 10th–90th $372–$7940%10%20%10th90th$676Professionalmedian $447 · 10th–90th $288–$6170%20%10th90th$447$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
$371.54 / $371.54 / $446.68
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$257.04 / $371.54 / $602.56
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$676.08 / $707.95 / $812.83
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$354.81 / $354.81 / $354.81
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$478.63 / $501.19 / $501.19
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$363.08 / $363.08 / $501.19
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$575.44 / $575.44 / $1,071.52
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$177.83 / $380.19 / $436.52
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$269.15 / $436.52 / $575.44
Well Sense
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$630.96 / $630.96 / $933.25