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Molded Distal Cushion, Below-Knee

New Hampshire rates for HCPCS L5668

Addition to lower extremity, below knee (BK), molded distal cushion

Rates data updated July 2026.

How much does Molded Distal Cushion, Below-Knee cost?

$100

Typical negotiated rate. In New Hampshire, July 2026.

Insurers have agreed to pay about $100 for this service. The price depends on where it is billed: about $100 from a physician practice, and about $151 from a hospital or other facility. The two figures are alternatives, not parts of one bill.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 6 insurance carriers under federal price transparency rules.

Where it's billed changes the price

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$100$81.28 to $129
FacilityA hospital or hospital-owned outpatient department$151$100 to $162

How much rates vary

Facilitymedian $151 · 10th to 90th $83 to $186Professionalmedian $100 · 10th to 90th $65 to $129
$100$200facility $151professional $100

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$83.18
Median
$83.18
Typical High
$100.00
Aetna
Setting
Professional
Modifier
Global
Typical Low
$54.95
Median
$83.18
Typical High
$100.00
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$151.36
Median
$162.18
Typical High
$186.21
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$81.28
Median
$81.28
Typical High
$83.18
Cigna
Setting
Facility
Modifier
Global
Typical Low
$89.13
Median
$89.13
Typical High
$109.65
Cigna
Setting
Professional
Modifier
Global
Typical Low
$64.57
Median
$64.57
Typical High
$89.13
Harvard Pilgrim
Setting
Professional
Modifier
Global
Typical Low
$128.82
Median
$128.82
Typical High
$239.88
United
Setting
Facility
Modifier
Global
Typical Low
$37.15
Median
$83.18
Typical High
$91.20
United
Setting
Professional
Modifier
Global
Typical Low
$60.26
Median
$93.33
Typical High
$128.82
Well Sense
Setting
Facility
Modifier
Global
Typical Low
$144.54
Median
$144.54
Typical High
$213.80

Where New Hampshire sits

The same service costs 3.2 times more in Hawaii than in Delaware. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

New Hampshire· 14th of 51

$100

HI $186DE $57.54

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.