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New Hampshire rates for HCPCS L6621

Upper Extremity Prosthesis Addition Flexion/Extension Wrist With Or Without Friction For Use With External Powered Terminal Device

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,517.51 / $1,517.51 / $1,821.01
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,177.55 / $1,203.55 / $1,815.14
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,695.08 / $2,695.08 / $3,194.75
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,487.71 / $1,487.71 / $1,574.14
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,786.24 / $1,786.24 / $1,786.24
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,303.96 / $1,303.96 / $1,786.24
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,182.08 / $2,182.08 / $6,734.99
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,026.08 / $1,344.55 / $2,265.34
Well Sense
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,018.53 / $2,220.38 / $2,825.94