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New Hampshire rates for HCPCS 15758

Free Fascial Flap W/Microvascular Anastomosis

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.00 / $8,359.29 / $9,859.00
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,669.00 / $10,807.74 / $18,842.15
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9,565.00 / $9,565.00 / $9,565.00