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New Hampshire rates for HCPCS 73221

Mri Any Jt Upper Extremity W/O Contrast Matrl

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$93.65 / $127.50 / $247.02
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$332.30 / $425.00 / $1,320.50
Aetna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$90.32 / $127.50 / $247.02
Aetna
Facility/Professional
Professional
Modifier
52
Low / Median / High Price
$166.15 / $200.00 / $300.00
Aetna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$241.98 / $297.50 / $931.29
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$154.13 / $164.39 / $487.42
Ambetter
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$47.37 / $51.65 / $204.25
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$200.55 / $428.48 / $614.39
Anthem BCBS
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$61.78 / $132.00 / $186.67
Anthem BCBS
Facility/Professional
Professional
Modifier
50
Low / Median / High Price
$300.82 / $642.72 / $921.59
Anthem BCBS
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$138.77 / $296.48 / $425.12
Cigna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$64.58 / $64.58 / $64.58
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$276.33 / $476.81 / $1,026.13
Cigna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$77.34 / $131.63 / $190.99
Cigna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$193.53 / $335.58 / $888.46
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$229.59 / $408.03 / $756.29
Harvard Pilgrim
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$70.73 / $125.43 / $232.99
Harvard Pilgrim
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$158.86 / $282.33 / $523.29
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$289.26 / $349.52 / $653.44
United
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$67.23 / $118.52 / $197.00
United
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$203.92 / $244.69 / $517.28
Well Sense
Facility/Professional
Professional
Modifier
Low / Median / High Price
$265.83 / $358.87 / $503.48
Well Sense
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$52.46 / $62.29 / $85.07
Well Sense
Facility/Professional
Professional
Modifier
52
Low / Median / High Price
$108.48 / $130.18 / $146.44
Well Sense
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$211.45 / $255.59 / $411.31