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New Hampshire rates for HCPCS 12004

Simple Rpr Scalp/Neck/Ax/Genit/Trunk 7.6-12.5cm

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.00 / $473.71 / $1,749.77
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$62.82 / $97.82 / $306.08
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
$70.84 / $129.06 / $248.61
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$77.62 / $163.44 / $324.39
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$92.41 / $201.38 / $414.75
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
$176.83 / $226.68 / $452.89
Well Sense
Facility/Professional
Professional
Modifier
Low / Median / High Price
$63.32 / $115.27 / $180.43