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New Hampshire rates for HCPCS L5655

Addition to lower extremity, socket insert, below knee (BK) (Kemblo, Pelite, Aliplast, Plastazote or equal)

Facilitymedian $389 · 10th–90th $214–$4570%10%20%10th90th$389Professionalmedian $257 · 10th–90th $170–$3470%20%10th90th$257$100.0$200.0$500.0$1.0K

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
$213.80 / $213.80 / $257.04
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$151.36 / $213.80 / $346.74
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$389.05 / $416.87 / $467.74
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$199.53 / $199.53 / $208.93
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$218.78 / $218.78 / $275.42
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$162.18 / $162.18 / $218.78
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$331.13 / $331.13 / $616.60
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$97.72 / $213.80 / $239.88
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$147.91 / $245.47 / $331.13
Well Sense
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$363.08 / $363.08 / $537.03