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New Hampshire rates for HCPCS L5859

Addition To Lower Extremity Prosthesis Endoskeletal Knee-Shin System Powered And Programmable Flexion/Extension Assist Control Includes Any Type Motor(S)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9,936.04 / $9,936.04 / $11,923.30
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7,469.69 / $7,634.61 / $9,936.04
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$17,095.98 / $17,095.98 / $20,265.57
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5,672.80 / $5,672.80 / $5,672.80
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9,812.54 / $9,812.54 / $9,812.54
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8,340.66 / $8,340.66 / $9,812.54
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13,841.85 / $13,841.85 / $42,722.87
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5,686.00 / $8,528.99 / $12,169.09