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New Hampshire rates for HCPCS L8658

Interphalangeal Joint Spacer Silicone Or Equal Each. (Rvsd 1/1/04)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$275.02 / $275.02 / $330.02
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$164.84 / $213.41 / $275.02
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$220.02 / $220.02 / $233.77
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$228.90 / $228.90 / $228.90
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$194.57 / $194.57 / $235.77
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$395.46 / $395.46 / $1,220.58
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$162.44 / $243.67 / $389.17
Well Sense
Facility/Professional
Professional
Modifier
Low / Median / High Price
$321.99 / $354.19 / $450.79