go back

New Hampshire rates for HCPCS 57155

Insertion Uterine Tandem&/Vaginal Ovoids

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.00 / $1,560.04 / $6,067.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$196.42 / $348.38 / $447.79
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8,992.79 / $9,992.00 / $19,041.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$318.91 / $466.97 / $761.11
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$406.13 / $695.39 / $1,193.11
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$364.96 / $741.68 / $1,388.65
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8,035.00 / $8,035.00 / $8,035.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$488.57 / $613.72 / $2,025.44
Well Sense
Facility/Professional
Professional
Modifier
Low / Median / High Price
$243.21 / $346.59 / $531.63