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New Hampshire rates for HCPCS 95875

Ischemic limb exercise test with serial specimen(s) acquisition for muscle(s) metabolite(s)

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$102.33 / $131.83 / $186.21
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$128.82 / $199.53 / $309.03
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$128.82 / $208.93 / $457.09
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$134.90 / $213.80 / $338.84
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$134.90 / $208.93 / $398.11