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New Hampshire rates for HCPCS 0643T

Transcatheter left ventricular restoration device implantation including right and left heart catheterization and left ventriculography when performed, arterial approach

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.00 / $100.00 / $9,859.00
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8,512.20 / $16,990.29 / $28,054.57
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,623.87 / $2,157.89 / $3,013.49
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7,448.00 / $7,448.00 / $7,448.00
Well Sense
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,500.00 / $2,750.00 / $3,500.00