go back

New Hampshire rates for HCPCS 42104

Exc Lesion Palate Uvula W/O Closure

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.00 / $490.02 / $2,341.64
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$134.22 / $194.00 / $271.50
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,449.90 / $1,611.00 / $2,875.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$160.34 / $260.18 / $397.96
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,751.69 / $1,751.69 / $1,812.99
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$182.38 / $306.82 / $586.66
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$164.95 / $320.93 / $675.67
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$930.00 / $3,884.00 / $8,611.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$230.13 / $322.18 / $631.19
Well Sense
Facility/Professional
Professional
Modifier
Low / Median / High Price
$118.68 / $174.56 / $244.38