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New Hampshire rates for HCPCS D4264

Bone Repl Gr - Ret Nat Tooth - Ea Add Site Quad

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$106.69 / $198.40 / $203.07
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$118.00 / $203.33 / $277.94
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$231.90 / $364.38 / $715.76