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New Hampshire rates for HCPCS L6920

Wrist disarticulation, external power, self-suspended inner socket, removable forearm shell, Otto Bock or equal switch, cables, two batteries and one charger, switch control of terminal device

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,154.43 / $5,154.43 / $6,185.33
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,999.73 / $4,131.59 / $5,154.43
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9,154.21 / $9,154.21 / $10,851.41
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,893.57 / $4,893.57 / $5,111.57
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,541.83 / $6,541.83 / $6,541.83
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,775.54 / $4,775.54 / $6,728.28
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7,411.76 / $7,411.76 / $22,876.40
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,044.63 / $4,566.93 / $6,019.63
Well Sense
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6,856.22 / $7,541.84 / $9,598.70