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New Hampshire rates for HCPCS 51720

Bladder instillation of anticarcinogenic agent (including retention time)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.00 / $336.04 / $1,974.43
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$59.50 / $111.71 / $228.55
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,223.09 / $1,426.62 / $2,500.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$45.63 / $88.77 / $153.83
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,306.21 / $1,306.21 / $1,351.93
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$57.15 / $125.30 / $253.32
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$52.95 / $116.25 / $277.54
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,360.00 / $3,360.00 / $7,448.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$103.07 / $144.30 / $247.76
Well Sense
Facility/Professional
Professional
Modifier
Low / Median / High Price
$39.08 / $76.41 / $121.46