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New Hampshire rates for HCPCS 21151

Rcnstj Midface Lefort Ii W/Bone Grafts

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.00 / $2,995.66 / $9,859.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,908.23 / $2,067.28 / $2,361.19
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
$1,752.86 / $3,005.82 / $4,480.46
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,047.39 / $2,047.39 / $2,047.39
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,347.57 / $3,409.36 / $5,354.64
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,006.66 / $3,156.88 / $6,193.56
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
$2,049.17 / $2,727.19 / $5,099.99
Well Sense
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,420.36 / $1,562.40 / $1,988.50