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New Hampshire rates for HCPCS 65290

Repair of wound, extraocular muscle, tendon and/or Tenon's capsule

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,621.81 / $2,754.23 / $11,481.54
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$457.09 / $501.19 / $758.58
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,467.37 / $4,677.35 / $6,309.57
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$416.87 / $870.96 / $1,348.96
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$616.60 / $891.25 / $1,445.44
Harvard Pilgrim
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10,000.00 / $10,000.00 / $10,000.00
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$501.19 / $812.83 / $1,445.44
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10,000.00 / $10,000.00 / $10,000.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$512.86 / $741.31 / $1,445.44