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New Hampshire rates for HCPCS L5656

Addition To Lower Extremity Socket Insert Knee Disarticulation (Kemblo Pelite Aliplast Plastazote Or Equal)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$253.13 / $253.13 / $303.76
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$196.42 / $253.13 / $267.14
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$449.54 / $449.54 / $532.88
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$270.76 / $270.76 / $284.13
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$335.84 / $335.84 / $335.84
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$245.16 / $245.16 / $335.84
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$363.97 / $363.97 / $1,123.39
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$149.51 / $224.27 / $342.28
Well Sense
Facility/Professional
Professional
Modifier
Low / Median / High Price
$336.69 / $370.36 / $471.37