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New Hampshire rates for HCPCS L5975

All lower extremity prostheses, combination single axis ankle and flexible keel foot

Facilitymedian $562 · 10th–90th $309–$6610%20%40%10th90th$562Professionalmedian $372 · 10th–90th $251–$5130%20%10th90th$372$200.0$500.0$1.0K$2.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$309.03 / $309.03 / $371.54
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$234.42 / $309.03 / $457.09
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$562.34 / $588.84 / $676.08
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$302.00 / $302.00 / $302.00
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$363.08 / $363.08 / $398.11
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$263.03 / $263.03 / $363.08
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$478.63 / $478.63 / $891.25
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$154.88 / $338.84 / $371.54
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$229.09 / $371.54 / $478.63
Well Sense
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$524.81 / $524.81 / $776.25