go back

New Hampshire rates for HCPCS 21087

Impression & Preparation Nasal Prosthesis

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,153.17 / $5,486.49 / $6,124.30
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,443.64 / $1,759.05 / $2,076.64
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,769.10 / $5,299.00 / $8,600.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,261.51 / $2,082.79 / $2,952.01
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,222.92 / $2,222.92 / $2,222.92
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,808.05 / $2,873.94 / $4,730.22
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,555.89 / $2,614.16 / $4,997.76
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$11,155.00 / $11,155.00 / $11,155.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,895.07 / $2,768.75 / $4,614.59
Well Sense
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,071.83 / $1,310.38 / $1,572.46