go back

New Hampshire rates for HCPCS Q2004

Bladder Calculi Irrig Sol

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$103.22 / $103.22 / $123.86
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$103.22 / $103.22 / $103.22
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$120.97 / $151.79 / $416.48
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$101.19 / $103.21 / $103.21
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$11.82 / $11.82 / $11.82
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$140.09 / $171.86 / $318.58
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$101.19 / $101.19 / $206.44
Well Sense
Facility/Professional
Professional
Modifier
Low / Median / High Price
$97.54 / $107.29 / $136.56