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New Hampshire rates for HCPCS L5639

Addition to lower extremity, below knee (BK), wood socket

Facilitymedian $1,820 · 10th–90th $1,000–$2,1880%20%40%10th90th$1,820Professionalmedian $1,202 · 10th–90th $741–$1,6980%20%10th90th$1,202$500.0$1.0K$2.0K$5.0K

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
$1,000.00 / $1,000.00 / $1,202.26
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$616.60 / $1,000.00 / $1,288.25
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,819.70 / $1,949.84 / $2,238.72
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$812.83 / $812.83 / $812.83
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$870.96 / $870.96 / $1,318.26
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$630.96 / $630.96 / $870.96
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,584.89 / $1,584.89 / $2,884.03
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$416.87 / $912.01 / $1,513.56
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$676.08 / $1,023.29 / $1,584.89
Well Sense
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,737.80 / $1,737.80 / $2,570.40