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New Hampshire rates for HCPCS L6715

Terminal Device Multiple Articulating Digit Includes Motor(S) Initial Issue Or Replacement (Reinstated Code Previous Description Was Terminal Device Hook Dorrance Or Equal Model # 5xa (Special Coverage Instructions Apply. See Mcm: 2133)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,443.00 / $2,443.00 / $2,931.60
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,625.35 / $1,661.24 / $2,443.00
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,719.97 / $3,719.97 / $4,409.64
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$178.70 / $3,053.24 / $3,053.24
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,381.07 / $2,381.07 / $2,381.07
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,738.18 / $1,738.18 / $2,381.07
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,011.89 / $3,011.89 / $9,296.20
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,237.23 / $1,855.85 / $2,618.15