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New Hampshire rates for HCPCS A4364

Adhesive, liquid or equal, any type, per oz

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2.16 / $2.16 / $2.59
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.76 / $2.16 / $2.77
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.87 / $1.87 / $1.87
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.80 / $4.80 / $4.80
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.10 / $2.10 / $2.10
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.28 / $3.28 / $4.97
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.37 / $2.04 / $2.93
Well Sense
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.71 / $3.25 / $4.78