go back

New Hampshire rates for HCPCS L5780

Addition Exoskeletal Knee-Shin System Single Axis Pneumatic/Hydra Pneumatic Swing Phase Control

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$824.63 / $824.63 / $989.56
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$638.16 / $639.89 / $824.63
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,464.54 / $1,464.54 / $1,736.07
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$839.51 / $839.51 / $876.91
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,036.33 / $1,036.33 / $1,036.33
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$756.53 / $756.53 / $1,067.43
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,185.76 / $1,185.76 / $3,659.85
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$572.08 / $782.84 / $1,185.76
Well Sense
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,096.89 / $1,206.58 / $1,535.65