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New Hampshire rates for HCPCS 96910

Photochemotherapy; tar and ultraviolet B (Goeckerman treatment) or petrolatum and ultraviolet B

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$202.12 / $202.12 / $202.12
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$73.09 / $77.59 / $197.22
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$113.54 / $155.79 / $258.14
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$92.15 / $158.37 / $330.84
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$129.97 / $252.03 / $401.18
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$82.91 / $178.79 / $414.75
Well Sense
Facility/Professional
Professional
Modifier
Low / Median / High Price
$63.31 / $109.23 / $167.54