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New Hampshire rates for HCPCS 21155

Rcnstj Midface Lefort Iii W/Lefort I

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.00 / $3,575.98 / $9,859.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,183.87 / $2,224.39 / $2,821.21
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
$2,093.46 / $3,496.74 / $5,351.10
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,447.00 / $2,447.00 / $2,447.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,799.11 / $4,102.32 / $6,351.71
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,396.58 / $3,770.30 / $7,397.04
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
$2,462.35 / $3,288.21 / $6,077.65
Well Sense
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,694.57 / $1,864.03 / $2,372.40