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New Hampshire rates for HCPCS L5646

Addition to lower extremity, below knee (BK), air, fluid, gel or equal, cushion socket

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$489.78 / $489.78 / $588.84
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$295.12 / $426.58 / $616.60
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$891.25 / $954.99 / $1,096.48
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$398.11 / $398.11 / $416.87
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$407.38 / $407.38 / $645.65
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$302.00 / $302.00 / $407.38
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$758.58 / $758.58 / $1,348.96
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$204.17 / $436.52 / $489.78
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$331.13 / $467.74 / $758.58
Well Sense
Facility/Professional
Facility
Modifier
Low / Median / High Price
$776.25 / $776.25 / $1,258.93