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New Hampshire rates for HCPCS G0501

Resource-intensive services for patients for whom the use of specialized mobility-assistive technology (such as adjustable height chairs or tables, patient lift, and adjustable padded leg supports) is medically necessary and used during the provision of an office/outpatient, evaluation and management visit (list separately in addition to primary service)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$18.20 / $18.20 / $21.88
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$18.20 / $18.20 / $18.20
Well Sense
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,511.89 / $2,511.89 / $2,511.89
Well Sense
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,511.89 / $2,511.89 / $2,511.89