go back

New Hampshire rates for HCPCS L5640

Addition to lower extremity, knee disarticulation, leather socket

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$432.14 / $432.14 / $518.57
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$335.33 / $419.06 / $445.32
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$767.47 / $767.47 / $909.76
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$468.88 / $468.88 / $489.76
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$572.20 / $572.20 / $572.20
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$417.71 / $417.71 / $572.20
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$621.39 / $621.39 / $1,917.92
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$255.26 / $382.88 / $576.76
Well Sense
Facility/Professional
Professional
Modifier
Low / Median / High Price
$574.80 / $632.29 / $804.73