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New Hampshire rates for HCPCS L6692

Upper extremity addition, silicone gel insert or equal, with or without locking mechanism, each

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$416.87 / $416.87 / $501.19
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$302.00 / $398.11 / $616.60
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$758.58 / $812.83 / $933.25
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$407.38 / $407.38 / $407.38
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$416.87 / $416.87 / $549.54
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$309.03 / $309.03 / $416.87
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$660.69 / $660.69 / $1,148.15
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$204.17 / $457.09 / $501.19
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$295.12 / $398.11 / $660.69
Well Sense
Facility/Professional
Facility
Modifier
Low / Median / High Price
$676.08 / $676.08 / $1,071.52