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New Hampshire rates for HCPCS 0575T

Programming device evaluation (in person) of implantable cardioverter-defibrillator system with substernal electrode, with iterative adjustment of the implantable device to test the function of the device and select optimal permanent programmed values with analysis, review and report by a physician or other qualified health care professional

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.74 / $60.74 / $67.11
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$67.06 / $95.26 / $133.03
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$90.01 / $167.15 / $287.87
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7,448.00 / $7,448.00 / $7,448.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$78.95 / $101.23 / $193.57
Well Sense
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,500.00 / $2,750.00 / $3,500.00