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New Hampshire rates for HCPCS L5656

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

Facilitymedian $457 · 10th–90th $251–$5500%20%40%10th90th$457Professionalmedian $347 · 10th–90th $219–$5010%20%10th90th$347$200.0$500.0$1.0K$2.0K

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
$251.19 / $251.19 / $302.00
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$204.17 / $251.19 / $501.19
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$457.09 / $489.78 / $562.34
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$269.15 / $269.15 / $269.15
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$331.13 / $338.84 / $338.84
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$245.47 / $245.47 / $338.84
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$389.05 / $389.05 / $724.44
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$138.04 / $302.00 / $331.13
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$204.17 / $331.13 / $389.05
Well Sense
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$436.52 / $436.52 / $645.65