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New Hampshire rates for HCPCS L5692

Addition to lower extremity, above knee (AK), pelvic control belt, light

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$106.22 / $106.22 / $127.46
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$73.58 / $82.42 / $127.04
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$188.62 / $188.62 / $223.59
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$96.39 / $96.39 / $101.78
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$99.66 / $99.66 / $99.66
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$72.75 / $72.75 / $106.24
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$152.72 / $152.72 / $471.40
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$62.74 / $94.10 / $126.63
Well Sense
Facility/Professional
Professional
Modifier
Low / Median / High Price
$141.28 / $155.41 / $197.79