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New Hampshire rates for HCPCS 64490

Njx Dx/Ther Agt Pvrt Facet Jt Crv/Thrc 1 Level

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.00 / $291.91 / $8,965.00
Aetna
Facility/Professional
Facility
Modifier
50
Low / Median / High Price
$4,252.78 / $6,693.82 / $6,693.82
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$111.80 / $177.69 / $291.91
Aetna
Facility/Professional
Professional
Modifier
50
Low / Median / High Price
$680.00 / $680.00 / $723.45
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,223.09 / $1,359.00 / $3,300.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$102.21 / $176.82 / $258.58
Anthem BCBS
Facility/Professional
Professional
Modifier
50
Low / Median / High Price
$153.31 / $264.02 / $387.42
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$178.63 / $1,306.21 / $1,351.93
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$147.47 / $259.54 / $470.29
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$127.73 / $245.18 / $529.62
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
$221.56 / $329.13 / $559.82
Well Sense
Facility/Professional
Professional
Modifier
Low / Median / High Price
$91.11 / $154.19 / $253.01