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New Hampshire rates for HCPCS L5695

Addition to lower extremity, above knee (AK), pelvic control, sleeve suspension, neoprene or equal, each

Facilitymedian $224 · 10th–90th $123–$2690%20%40%10th90th$224Professionalmedian $148 · 10th–90th $100–$2040%20%10th90th$148$100.0$200.0$500.0$1.0K

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
$123.03 / $123.03 / $147.91
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$95.50 / $123.03 / $162.18
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$223.87 / $239.88 / $275.42
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$120.23 / $120.23 / $123.03
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$123.03 / $123.03 / $162.18
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$89.13 / $89.13 / $123.03
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$194.98 / $194.98 / $354.81
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$60.26 / $131.83 / $147.91
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$91.20 / $147.91 / $194.98
Well Sense
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$213.80 / $213.80 / $316.23