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New Hampshire rates for HCPCS L5643

Addition to lower extremity, hip disarticulation, flexible inner socket, external frame

Facilitymedian $2,512 · 10th–90th $1,413–$3,0200%20%40%10th90th$2,512Professionalmedian $1,660 · 10th–90th $955–$2,3440%20%10th90th$1,660$1.0K$2.0K$5.0K$10.0K

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
$1,412.54 / $1,412.54 / $1,698.24
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$812.83 / $1,202.26 / $1,819.70
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,511.89 / $2,691.53 / $3,090.30
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,122.02 / $1,122.02 / $1,122.02
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,174.90 / $1,174.90 / $1,819.70
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$851.14 / $851.14 / $1,174.90
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,187.76 / $2,187.76 / $3,981.07
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$575.44 / $1,230.27 / $1,412.54
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$933.25 / $1,412.54 / $2,187.76
Well Sense
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,398.83 / $2,398.83 / $3,548.13