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New Hampshire rates for HCPCS 15770

Graft Derma-Fat-Fascia

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.00 / $2,309.04 / $9,859.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$506.21 / $611.73 / $766.37
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,302.10 / $3,669.21 / $6,000.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$661.81 / $1,008.78 / $1,664.02
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
$697.08 / $996.23 / $1,734.23
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$757.63 / $1,493.14 / $2,695.57
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9,949.00 / $9,949.00 / $9,949.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$729.50 / $911.03 / $2,315.65
Well Sense
Facility/Professional
Professional
Modifier
Low / Median / High Price
$524.32 / $629.17 / $993.06