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New Hampshire rates for HCPCS 40804

Rmvl Embedded Fb Vestibule Mouth Smpl

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.00 / $457.95 / $2,331.21
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$137.25 / $225.15 / $457.95
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,223.09 / $1,359.00 / $3,300.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$137.04 / $237.95 / $387.70
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$168.58 / $304.33 / $516.44
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$151.47 / $332.47 / $676.62
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
$272.18 / $382.06 / $738.10
Well Sense
Facility/Professional
Professional
Modifier
Low / Median / High Price
$103.68 / $159.16 / $230.60