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New Hampshire rates for HCPCS C9758

Blinded Procedure For Nyha Class Iii/Iv Heart Failure; Transcatheter Implantation Of Interatrialshunt Or Placebo Control Including Right Heart Catheterization Trans-Esophageal Echocardiography(Tee)/Intracardiac Echocardiography (Ice) And Allimaging With Or Without Guidance (E.G. Ultrasoundfluoroscopy) Performed In An Approved Investigational Device Exemption (Ide) Study

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.00 / $100.00 / $9,859.00
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8,992.79 / $9,992.00 / $19,050.00
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$26,762.50 / $42,720.46 / $60,146.16
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$12,629.00 / $12,629.00 / $12,629.00
Well Sense
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,500.00 / $2,750.00 / $3,500.00