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New Hampshire rates for HCPCS 96522

Refilling and maintenance of implantable pump or reservoir for drug delivery, systemic (eg, intravenous, intra-arterial)

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$113.16 / $139.74 / $154.40
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$108.36 / $264.77 / $429.29
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$128.68 / $208.24 / $332.61
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$124.05 / $204.50 / $408.63
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$127.35 / $171.28 / $274.77
Well Sense
Facility/Professional
Professional
Modifier
Low / Median / High Price
$99.07 / $118.15 / $174.76