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New Hampshire rates for HCPCS L5782

Addition To Lower Limb Prosthesis Vacuum Pump Residual Limb Volume Management And Moisture Evacuation System Heavy Duty

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,798.51 / $2,798.51 / $3,358.21
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,171.58 / $2,219.53 / $3,347.37
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,970.12 / $4,970.12 / $5,891.58
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,779.11 / $2,779.11 / $2,902.90
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,294.10 / $3,294.10 / $3,294.10
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,404.69 / $2,404.69 / $3,294.10
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,024.08 / $4,024.08 / $12,420.32
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,653.02 / $2,479.54 / $3,418.60
Well Sense
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,722.46 / $4,094.71 / $5,211.43