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New Hampshire rates for HCPCS 15200

Fth/Gft Free W/Direct Closure Trunk 20 Sq Cm/<

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,196.32 / $2,331.21 / $2,812.49
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$505.71 / $651.88 / $893.92
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,449.90 / $1,611.00 / $3,700.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$659.22 / $1,019.79 / $1,591.01
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,000.36 / $2,000.36 / $2,070.38
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$732.41 / $1,246.35 / $2,087.54
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$859.87 / $1,671.59 / $2,685.04
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9,565.00 / $9,565.00 / $9,565.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$766.10 / $1,280.25 / $2,947.31
Well Sense
Facility/Professional
Professional
Modifier
Low / Median / High Price
$569.04 / $715.43 / $996.66