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New Hampshire rates for HCPCS A2005

Microlyte Matrix, per sq cm (add-on, list separately in addition to primary procedure)

Facilitymedian $234 · 10th–90th $145–$3,9810%20%10th90th$234Professionalmedian $195 · 10th–90th $126–$2950%20%10th90th$195$1.0$5.0$20.0$100.0$500.0$2.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$131.83 / $194.98 / $234.42
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$158.49 / $194.98 / $245.47
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $125.89
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$144.54 / $251.19 / $338.84
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $125.89
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$141.25 / $208.93 / $323.59
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $302.00
Well Sense
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,630.78 / $3,981.07 / $5,754.40