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New Hampshire rates for HCPCS L5701

Replacement, socket, above knee (AK)/knee disarticulation, including attachment plate, molded to patient model

Facilitymedian $4,467 · 10th–90th $2,455–$5,2480%20%40%10th90th$4,467Professionalmedian $2,951 · 10th–90th $1,905–$4,4670%20%10th90th$2,951$2.0K$5.0K$10.0K$20.0K

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
$2,454.71 / $2,454.71 / $2,951.21
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,819.70 / $2,454.71 / $4,466.84
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4,466.84 / $4,677.35 / $5,370.32
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,454.71 / $2,454.71 / $2,570.40
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,570.40 / $2,570.40 / $3,162.28
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,862.09 / $1,862.09 / $2,570.40
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,801.89 / $3,801.89 / $7,079.46
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,258.93 / $2,818.38 / $3,090.30
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,862.09 / $3,090.30 / $3,801.89
Well Sense
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4,168.69 / $4,168.69 / $6,165.95