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New Hampshire rates for HCPCS M0201

Administration Of Pneumococcal Influenza Hepatis B And/Or Covid-19 Vaccine Inside A Patients Home; Reported Only Once Per Individual Home Per Date Of Service When Such Vaccine Administration(S) Are Performed At The Patients Home (Desc Rvsd 1/1/2024)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$40.34 / $40.34 / $40.34
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$40.34 / $40.34 / $40.34
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$31.89 / $31.89 / $31.89
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$42.20 / $67.40 / $132.49
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$37.40 / $47.85 / $77.93
Well Sense
Facility/Professional
Professional
Modifier
Low / Median / High Price
$40.27 / $44.30 / $56.38