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New Hampshire rates for HCPCS 66174

Trluml Dilat Aqueous O/F Can Wo Retention Dev/St

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.00 / $2,331.21 / $15,774.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$945.28 / $946.67 / $1,799.00
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,769.10 / $5,299.00 / $8,600.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$599.70 / $943.33 / $1,626.95
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$791.80 / $1,223.71 / $1,937.37
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$755.19 / $1,233.27 / $2,442.64
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$11,155.00 / $11,155.00 / $11,155.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,280.80 / $1,567.10 / $2,766.19
Well Sense
Facility/Professional
Professional
Modifier
Low / Median / High Price
$790.16 / $948.19 / $1,401.67