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New Hampshire rates for HCPCS 0704T

Remote treatment of amblyopia using an eye tracking device; device supply with initial set-up and patient education on use of equipment

Insurance Carrier
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$44.41 / $69.41 / $100.64
Well Sense
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,500.00 / $2,750.00 / $3,500.00