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New Hampshire rates for HCPCS L5925

Addition, endoskeletal system, above knee (AK), knee disarticulation or hip disarticulation, manual lock

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$227.08 / $227.08 / $272.50
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$176.21 / $180.10 / $271.62
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$282.30 / $282.30 / $282.30
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$403.29 / $403.29 / $478.06
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$257.35 / $321.33 / $321.33
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$260.88 / $260.88 / $260.88
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$190.44 / $190.44 / $278.11
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$326.52 / $326.52 / $1,007.80
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$134.13 / $201.20 / $303.07
Well Sense
Facility/Professional
Professional
Modifier
Low / Median / High Price
$302.05 / $332.26 / $422.87