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New Hampshire rates for HCPCS Q4121

TheraSkin, per sq cm (add-on, list separately in addition to primary procedure)

Facilitymedian $63 · 10th–90th $26–$2510%20%10th90th$63Professionalmedian $52 · 10th–90th $52–$1260%50%90th$52$20.0$50.0$100.0$200.0

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$52.48 / $63.10 / $131.83
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$52.48 / $52.48 / $67.61
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $125.89
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$144.54 / $251.19 / $338.84
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $125.89 / $125.89
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$52.48 / $52.48 / $97.72
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$45.71 / $52.48 / $125.89
Well Sense
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$23.44 / $23.99 / $25.70