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New Hampshire rates for HCPCS 42815

Excision branchial cleft cyst, vestige, or fistula, extending beneath subcutaneous tissues and/or into pharynx

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,995.26 / $2,398.83 / $15,848.93
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,011.87 / $5,623.41 / $8,912.51
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,951.21 / $2,951.21 / $2,951.21
Harvard Pilgrim
Facility/Professional
Facility
Modifier
Low / Median / High Price
$977.24 / $4,570.88 / $11,220.18
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$977.24 / $4,570.88 / $11,220.18
Well Sense
Facility/Professional
Facility
Modifier
Low / Median / High Price
$416.87 / $562.34 / $691.83