go back

New Hampshire rates for HCPCS L5672

Addition To Lower Extremity Below Knee Removable Medial Brim Suspension

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$236.94 / $236.94 / $284.33
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$170.25 / $202.54 / $236.94
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$420.80 / $420.80 / $498.82
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$217.64 / $217.64 / $228.39
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$297.81 / $297.81 / $297.81
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$217.40 / $217.40 / $306.74
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$340.71 / $340.71 / $1,051.59
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$139.96 / $209.93 / $281.52
Well Sense
Facility/Professional
Professional
Modifier
Low / Median / High Price
$315.16 / $346.68 / $441.22