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New Hampshire rates for HCPCS 14301

Adjacent tissue transfer or rearrangement, any area; defect 30.1 sq cm to 60.0 sq cm

Facilitymedian $2,754 · 10th–90th $832–$9,7720%10%10th90th$2,754Professionalmedian $1,175 · 10th–90th $288–$2,6300%5%10%10th90th$1,175$100.0$200.0$500.0$1.0K$2.0K$5.0K$10.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$831.76 / $2,754.23 / $9,772.37
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$776.25 / $1,023.29 / $2,630.27
Aetna
Facility/Professional
Professional
Modifier
AS
Typical Low / Median / Typical High
$257.04 / $257.04 / $257.04
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,467.37 / $4,677.35 / $6,309.57
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$776.25 / $1,348.96 / $2,041.74
Anthem BCBS
Facility/Professional
Professional
Modifier
AS
Typical Low / Median / Typical High
$107.15 / $190.55 / $288.40
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5,495.41 / $5,495.41 / $5,495.41
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$933.25 / $1,380.38 / $2,630.27
Harvard Pilgrim
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$10,000.00 / $10,000.00 / $10,000.00
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$933.25 / $1,621.81 / $2,951.21
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$10,000.00 / $10,000.00 / $10,000.00
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$954.99 / $1,513.56 / $3,090.30