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New Hampshire rates for HCPCS 17004

Destruction Premalignant Lesion 15/>

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$175.43 / $591.30 / $2,331.21
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$87.38 / $155.38 / $357.33
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,223.09 / $1,359.00 / $3,300.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$96.39 / $150.44 / $238.28
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,306.21 / $1,306.21 / $1,351.93
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$111.98 / $221.62 / $424.37
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$125.73 / $270.99 / $519.73
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
$202.11 / $240.90 / $561.55
Well Sense
Facility/Professional
Professional
Modifier
Low / Median / High Price
$84.66 / $132.11 / $188.91