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New Hampshire rates for HCPCS 11976

Removal Implantable Contraceptive Capsules

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$160.34 / $530.99 / $2,331.21
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$80.31 / $124.20 / $324.14
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,223.09 / $1,359.00 / $3,300.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$89.28 / $158.18 / $270.88
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,306.21 / $1,306.21 / $1,351.93
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$101.28 / $204.76 / $359.95
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$116.45 / $243.17 / $450.09
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8,035.00 / $8,035.00 / $8,035.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$165.79 / $236.05 / $507.33
Well Sense
Facility/Professional
Professional
Modifier
Low / Median / High Price
$73.48 / $114.65 / $160.51