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New Hampshire rates for HCPCS A6258

Transparent Film More Than 16 Sq. In. But Less Than Or Equal To 48 Sq. In. Each Dressing

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3.16 / $3.16 / $3.79
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.63 / $3.16 / $4.07
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.67 / $2.67 / $2.67
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7.06 / $7.06 / $7.06
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3.07 / $3.07 / $3.07
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.90 / $4.90 / $7.43
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.00 / $3.00 / $4.90
Well Sense
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4.05 / $4.86 / $7.14