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New Hampshire rates for HCPCS 21485

Closed Tx Temporomandibular Dislc Comp 1st/Sbsq

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.00 / $1,965.86 / $2,341.64
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$573.80 / $695.10 / $1,224.93
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,449.90 / $1,611.00 / $3,700.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$748.50 / $1,247.02 / $1,629.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,243.82 / $1,751.69 / $1,812.99
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$968.30 / $1,565.36 / $2,767.76
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$915.57 / $1,539.24 / $2,939.62
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8,611.00 / $8,611.00 / $8,611.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$662.50 / $1,315.83 / $2,476.44
Well Sense
Facility/Professional
Professional
Modifier
Low / Median / High Price
$583.66 / $716.98 / $860.38