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New Hampshire rates for HCPCS A2015

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

Facilitymedian $98 · 10th–90th $81–$3,9810%20%10th90th$98Professionalmedian $126 · 10th–90th $72–$2880%10%10th90th$126$50.0$100.0$200.0$500.0$1.0K$2.0K$5.0K

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
$81.28 / $97.72 / $131.83
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$66.07 / $83.18 / $114.82
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 / $316.23
Well Sense
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,630.78 / $3,981.07 / $5,754.40