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New Hampshire rates for HCPCS 52317

Litholapaxy Smpl/Sm <2.5 Cm

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.00 / $1,749.77 / $10,053.29
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$356.18 / $868.45 / $1,320.69
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,302.10 / $3,669.21 / $6,000.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$417.35 / $799.76 / $1,658.68
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$449.34 / $1,094.88 / $2,689.93
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$433.74 / $1,092.58 / $2,901.90
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9,565.00 / $9,565.00 / $9,565.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,205.35 / $1,668.96 / $2,878.96
Well Sense
Facility/Professional
Professional
Modifier
Low / Median / High Price
$298.10 / $703.73 / $1,125.29