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New Hampshire rates for HCPCS L5976

All lower extremity prostheses, energy storing foot (Seattle Carbon Copy II or equal)

Facilitymedian $832 · 10th–90th $468–$1,0000%10%20%10th90th$832Professionalmedian $550 · 10th–90th $363–$7240%20%10th90th$550$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
$467.74 / $467.74 / $562.34
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$302.00 / $467.74 / $630.96
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$831.76 / $891.25 / $1,023.29
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$407.38 / $407.38 / $426.58
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$416.87 / $416.87 / $602.56
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$309.03 / $309.03 / $416.87
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$724.44 / $724.44 / $1,318.26
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$208.93 / $457.09 / $501.19
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$323.59 / $512.86 / $724.44
Well Sense
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$794.33 / $794.33 / $1,174.90