go back

New Hampshire rates for HCPCS 13122

Repair, complex, scalp, arms, and/or legs; each additional 5 cm or less (List separately in addition to code for primary procedure)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.00 / $422.64 / $2,331.21
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$72.81 / $101.76 / $167.05
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$79.25 / $138.77 / $235.86
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$107.24 / $192.76 / $363.69
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$100.35 / $210.56 / $384.60
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
$135.47 / $213.30 / $461.55
Well Sense
Facility/Professional
Professional
Modifier
Low / Median / High Price
$72.33 / $102.60 / $145.61