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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

Facilitymedian $9,333 · 10th–90th $5,129–$10,9650%20%10th90th$9,333Professionalmedian $6,166 · 10th–90th $4,169–$8,5110%20%10th90th$6,166$5.0K$10.0K$20.0K

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
$5,128.61 / $5,128.61 / $6,165.95
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,467.37 / $5,011.87 / $7,762.47
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$9,332.54 / $10,000.00 / $11,481.54
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4,897.79 / $4,897.79 / $4,897.79
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$6,606.93 / $6,606.93 / $6,760.83
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$4,786.30 / $4,786.30 / $6,606.93
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$7,943.28 / $7,943.28 / $14,791.08
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,454.71 / $5,248.07 / $6,025.60
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,715.35 / $6,025.60 / $7,943.28
Well Sense
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$8,912.51 / $8,912.51 / $13,182.57