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New Hampshire rates for HCPCS 76641

Us Breast Uni Real Time With Image Complete

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$37.11 / $37.11 / $66.09
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$85.58 / $104.98 / $157.05
Aetna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$27.21 / $37.11 / $72.80
Aetna
Facility/Professional
Professional
Modifier
50
Low / Median / High Price
$46.70 / $141.08 / $208.00
Aetna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$58.37 / $70.84 / $128.71
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$76.25 / $76.25 / $80.59
Ambetter
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$25.44 / $38.88 / $79.38
Ambetter
Facility/Professional
Professional
Modifier
50
Low / Median / High Price
$114.37 / $114.37 / $120.89
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$98.98 / $145.32 / $203.75
Anthem BCBS
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$33.64 / $49.39 / $69.23
Anthem BCBS
Facility/Professional
Professional
Modifier
50
Low / Median / High Price
$148.47 / $217.98 / $305.62
Anthem BCBS
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$65.34 / $95.93 / $134.50
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$128.09 / $198.72 / $320.33
Cigna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$41.90 / $63.68 / $102.95
Cigna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$85.32 / $131.66 / $215.27
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$113.31 / $199.01 / $373.25
Harvard Pilgrim
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$38.51 / $66.61 / $118.86
Harvard Pilgrim
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$74.80 / $129.38 / $230.87
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$114.82 / $139.58 / $244.30
United
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$38.03 / $46.65 / $91.24
United
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$78.54 / $92.93 / $163.09
Well Sense
Facility/Professional
Professional
Modifier
Low / Median / High Price
$85.56 / $99.93 / $150.93
Well Sense
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$27.73 / $32.61 / $46.63
Well Sense
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$57.21 / $67.31 / $97.10