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New Hampshire rates for HCPCS 0558T

Computed tomography scan taken for the purpose of biomechanical computed tomography analysis

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$173.31 / $205.90 / $225.92
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$97.74 / $97.74 / $127.23
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$529.92 / $529.92 / $943.02
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$252.91 / $423.80 / $833.11
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$228.68 / $292.38 / $587.37
Well Sense
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,500.00 / $2,750.00 / $3,500.00