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New Hampshire rates for HCPCS A4354

Insertion Tray With Drainage Bag But Without Catheter (Special Coverage Instructions Apply. See Mcm: 2130)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7.36 / $7.36 / $8.83
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.21 / $7.36 / $9.90
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.43 / $7.43 / $7.43
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$19.32 / $19.32 / $19.32
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.42 / $8.42 / $8.42
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13.44 / $13.44 / $20.38
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.66 / $6.99 / $11.17
Well Sense
Facility/Professional
Professional
Modifier
Low / Median / High Price
$11.09 / $13.31 / $19.55