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New Hampshire rates for HCPCS G0468

Federally Qualified Health Center (FQHC) visit, IPPE or AWV; a FQHC visit that includes an initial preventive physical examination (IPPE) or annual wellness visit (AWV) and includes a typical bundle of Medicare-covered services that would be furnished per diem to a patient receiving an IPPE or AWV

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$118.13 / $118.13 / $118.13
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$118.13 / $118.13 / $130.08
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$94.50 / $319.16 / $368.30
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13.17 / $13.17 / $13.17
Well Sense
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,500.00 / $3,000.00 / $4,410.00