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New Hampshire rates for HCPCS G0403

Electrocardiogram, routine ECG with 12 leads; performed as a screening for the initial preventive physical examination with interpretation and report

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.95 / $17.46 / $21.43
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13.91 / $28.54 / $48.66
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12.80 / $12.80 / $12.80
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.92 / $25.14 / $52.44
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$17.75 / $28.40 / $50.31
Well Sense
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14.47 / $18.09 / $3,375.00