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New Hampshire rates for HCPCS 61640

Balloon Dilat Intracranial Vasospasm Prq Initial

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.00 / $2,407.10 / $9,859.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$641.50 / $910.91 / $910.91
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8,512.20 / $9,458.00 / $17,400.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$486.22 / $806.87 / $1,248.49
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$721.71 / $1,089.56 / $1,379.10
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$519.00 / $990.84 / $1,708.95
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7,448.00 / $7,448.00 / $7,448.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$656.03 / $841.00 / $1,420.96
Well Sense
Facility/Professional
Professional
Modifier
Low / Median / High Price
$405.01 / $497.06 / $697.35