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New Hampshire rates for HCPCS L5651

Addition to lower extremity, above knee (AK), flexible inner socket, external frame

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,082.13 / $1,082.13 / $1,298.56
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$643.69 / $839.71 / $1,083.21
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,921.85 / $1,921.85 / $2,278.16
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$874.06 / $874.06 / $919.80
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,200.11 / $1,200.11 / $1,200.11
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$876.09 / $876.09 / $1,407.32
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,556.04 / $1,556.04 / $4,802.72
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$639.20 / $958.79 / $1,138.45
Well Sense
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,439.40 / $1,583.34 / $2,015.16