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New Hampshire rates for HCPCS 21497

Interdental Wiring Other Than Fracture

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.00 / $1,989.54 / $2,341.64
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$597.62 / $726.71 / $896.03
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
$585.85 / $946.73 / $1,322.10
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$959.91 / $1,751.69 / $1,812.99
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$803.88 / $1,279.79 / $2,013.77
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$701.12 / $1,166.15 / $2,211.98
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
$669.50 / $1,057.33 / $2,075.46
Well Sense
Facility/Professional
Professional
Modifier
Low / Median / High Price
$462.13 / $623.88 / $801.33