go back

New Hampshire rates for HCPCS Q4173

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$356.55 / $356.55 / $427.86
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$349.02 / $349.02 / $418.82
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$349.02 / $349.02 / $349.02
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$329.26 / $349.01 / $349.01
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$349.01 / $349.01 / $349.01
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$349.02 / $349.02 / $506.57
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$349.02 / $349.02 / $837.65
Well Sense
Facility/Professional
Professional
Modifier
Low / Median / High Price
$408.00 / $448.80 / $571.20