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New Hampshire rates for HCPCS L5781

Addition to lower limb prosthesis, vacuum pump, residual limb volume management and moisture evacuation system

Facilitymedian $4,786 · 10th–90th $2,630–$5,7540%10%20%10th90th$4,786Professionalmedian $3,162 · 10th–90th $2,089–$4,1690%20%10th90th$3,162$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
$2,630.27 / $2,630.27 / $3,162.28
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,041.74 / $2,630.27 / $3,981.07
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4,786.30 / $5,128.61 / $5,888.44
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,884.03 / $2,884.03 / $3,019.95
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,884.03 / $2,884.03 / $3,467.37
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,089.30 / $2,089.30 / $2,884.03
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4,168.69 / $4,168.69 / $7,585.78
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,318.26 / $2,951.21 / $3,235.94
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,995.26 / $3,235.94 / $4,168.69
Well Sense
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4,570.88 / $4,570.88 / $6,760.83