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New Hampshire rates for HCPCS L5961

Addition Endoskeletal System Polycentric Hip Joint Pneumatic Or Hydraulic Control With Or Without Flexion And/Or Extension Control

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,084.50 / $3,084.50 / $3,701.40
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,393.50 / $2,438.50 / $3,689.44
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,478.02 / $5,478.02 / $6,493.64
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,159.00 / $3,569.66 / $3,569.66
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,728.42 / $3,728.42 / $3,728.42
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,721.75 / $2,721.75 / $3,728.42
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,435.31 / $4,435.31 / $13,689.58
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,821.95 / $2,732.92 / $3,856.19
Well Sense
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,102.85 / $4,513.14 / $5,744.00