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New Hampshire rates for HCPCS 21387

Open Tx Orbital Floor Blowout Fx Combined Appr

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
$661.63 / $726.19 / $993.06
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
$750.76 / $1,250.80 / $1,919.03
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$863.37 / $863.37 / $863.37
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$984.03 / $1,365.74 / $2,266.29
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$859.47 / $1,410.05 / $2,652.75
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
$879.07 / $1,142.19 / $2,194.06
Well Sense
Facility/Professional
Professional
Modifier
Low / Median / High Price
$620.15 / $682.17 / $868.21