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New Hampshire rates for HCPCS 21255

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Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.00 / $2,331.21 / $9,859.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,229.11 / $1,429.32 / $1,748.33
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
$1,296.45 / $2,223.16 / $3,313.82
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,490.92 / $1,490.92 / $1,490.92
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,769.27 / $2,532.48 / $3,956.50
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,484.16 / $2,334.88 / $4,580.85
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
$1,527.38 / $2,169.00 / $8,817.65
Well Sense
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,085.82 / $1,194.40 / $1,520.15