go back

New Hampshire rates for HCPCS L5940

Addition, endoskeletal system, below knee (BK), ultra-light material (titanium, carbon fiber or equal)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$338.84 / $338.84 / $407.38
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$269.15 / $295.12 / $630.96
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$616.60 / $660.69 / $741.31
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$363.08 / $363.08 / $389.05
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$380.19 / $380.19 / $446.68
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$281.84 / $281.84 / $380.19
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$524.81 / $524.81 / $912.01
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$186.21 / $398.11 / $457.09
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$234.42 / $323.59 / $524.81
Well Sense
Facility/Professional
Facility
Modifier
Low / Median / High Price
$537.03 / $537.03 / $870.96