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New Hampshire rates for HCPCS L5960

Addition, endoskeletal system, hip disarticulation, ultra-light material (titanium, carbon fiber or equal)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$724.44 / $724.44 / $870.96
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$524.81 / $691.83 / $1,023.29
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,318.26 / $1,412.54 / $1,584.89
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$691.83 / $691.83 / $724.44
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$933.25 / $933.25 / $954.99
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$676.08 / $676.08 / $933.25
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,122.02 / $1,122.02 / $1,949.84
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$354.81 / $758.58 / $870.96
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$501.19 / $691.83 / $1,122.02
Well Sense
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,148.15 / $1,148.15 / $1,862.09