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New Hampshire rates for HCPCS 64738

Transection/Avulsion Inf Alveolar Nrv W/Osteo

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.00 / $1,618.95 / $6,067.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$481.98 / $492.11 / $728.41
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,449.90 / $1,611.00 / $3,700.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$440.24 / $761.54 / $1,168.38
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$506.28 / $1,751.69 / $1,812.99
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$566.44 / $827.23 / $1,242.83
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$503.98 / $826.83 / $1,555.53
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8,611.00 / $8,611.00 / $8,611.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$513.48 / $669.23 / $1,342.12
Well Sense
Facility/Professional
Professional
Modifier
Low / Median / High Price
$358.56 / $394.42 / $501.98