go back

New Hampshire rates for HCPCS 21172

Rcnstj Superior-Lateral Orbital Rim & Lower Fhd

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.00 / $3,519.37 / $9,859.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,659.22 / $1,906.52 / $2,828.88
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
$2,081.50 / $3,477.83 / $5,320.49
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,409.73 / $2,409.73 / $2,409.73
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,577.02 / $3,753.07 / $6,227.76
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,382.88 / $3,909.35 / $7,354.76
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
$2,201.54 / $3,218.29 / $5,962.80
Well Sense
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,630.31 / $1,793.34 / $2,282.42