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New Hampshire rates for HCPCS L5964

Addition, endoskeletal system, above knee (AK), flexible protective outer surface covering system

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
$537.03 / $676.08 / $1,148.15
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,318.26 / $1,380.38 / $1,584.89
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$676.08 / $676.08 / $707.95
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$707.95 / $707.95 / $933.25
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$512.86 / $512.86 / $707.95
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
$346.74 / $776.25 / $851.14
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$501.19 / $676.08 / $1,122.02
Well Sense
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,148.15 / $1,148.15 / $1,819.70