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New Hampshire rates for HCPCS L5790

Addition, exoskeletal system, above knee (AK), ultra-light material (titanium, carbon fiber or equal)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$647.90 / $647.90 / $777.48
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$385.39 / $502.76 / $666.38
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,150.66 / $1,150.66 / $1,363.99
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$520.50 / $520.50 / $550.74
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$582.20 / $582.20 / $582.20
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$425.01 / $425.01 / $620.66
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$931.64 / $931.64 / $2,875.51
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$500.36 / $500.36 / $500.36
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$382.70 / $574.05 / $681.62
Well Sense
Facility/Professional
Professional
Modifier
Low / Median / High Price
$861.81 / $947.99 / $1,206.53