go back

New Hampshire rates for HCPCS 74775

Perineogram (eg, vaginogram, for sex determination or extent of anomalies)

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$157.19 / $190.43 / $235.67
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$250.04 / $367.10 / $519.15
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$245.28 / $446.68 / $1,402.08
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$104.58 / $168.18 / $245.38
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$90.35 / $160.22 / $297.62
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$97.60 / $330.00 / $580.01
Well Sense
Facility/Professional
Professional
Modifier
Low / Median / High Price
$77.03 / $84.73 / $107.84