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New Hampshire rates for HCPCS 21145

Rcnstj Midface Lefort I 1 Piece W/Bone Grafts

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.00 / $2,583.27 / $9,859.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,397.30 / $1,631.72 / $2,435.44
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,299.00 / $16,696.31 / $29,108.25
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,505.41 / $2,581.50 / $3,847.96
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,738.56 / $1,738.56 / $1,738.56
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,975.44 / $2,922.70 / $4,566.13
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,723.38 / $2,711.22 / $5,319.21
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
$1,764.98 / $2,390.64 / $10,053.83
Well Sense
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,233.54 / $1,475.94 / $2,175.96