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New Hampshire rates for HCPCS 51725

Simple cystometrogram (CMG) (eg, spinal manometer)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$119.72 / $306.61 / $306.61
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$203.69 / $250.10 / $391.20
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$238.44 / $405.68 / $592.89
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$268.10 / $515.62 / $779.51
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$229.96 / $456.19 / $757.51
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$291.89 / $396.20 / $818.17
Well Sense
Facility/Professional
Professional
Modifier
Low / Median / High Price
$170.68 / $204.82 / $301.08