go back

New Hampshire rates for HCPCS 0412T

Removal of permanent cardiac contractility modulation system; pulse generator only

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.00 / $2,331.21 / $11,351.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$235.10 / $235.10 / $255.58
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,302.10 / $3,669.21 / $6,000.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$252.94 / $252.94 / $311.76
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$295.20 / $572.33 / $1,019.73
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9,949.00 / $9,949.00 / $9,949.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$271.02 / $392.21 / $884.91
Well Sense
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,500.00 / $2,750.00 / $3,500.00