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New Hampshire rates for HCPCS A5122

Skin barrier; solid, 8 x 8 or equivalent, each

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7.94 / $7.94 / $9.55
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6.03 / $9.55 / $19.95
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.94 / $7.94 / $8.51
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10.72 / $10.72 / $12.02
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9.12 / $9.12 / $11.22
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13.49 / $13.49 / $23.44
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4.68 / $6.03 / $7.24
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5.75 / $7.59 / $13.49
Well Sense
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10.23 / $10.23 / $16.60