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New Hampshire rates for HCPCS L5677

Additions to lower extremity, below knee (BK), knee joints, polycentric, pair

Facilitymedian $813 · 10th–90th $447$9550%20%40%10th90th$813Professionalmedian $537 · 10th–90th $309$7410%20%10th90th$537$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
$446.68 / $446.68 / $537.03
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$257.04 / $389.05 / $549.54
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$812.83 / $851.14 / $977.24
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$363.08 / $363.08 / $363.08
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$398.11 / $398.11 / $575.44
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$295.12 / $295.12 / $398.11
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$691.83 / $691.83 / $1,288.25
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$181.97 / $398.11 / $446.68
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$295.12 / $446.68 / $691.83
Well Sense
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$758.58 / $758.58 / $1,122.02