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New Hampshire rates for HCPCS Q4201

Matrion 1 sq cm

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$79.23 / $79.23 / $95.08
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$76.09 / $76.09 / $91.31
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$76.09 / $76.09 / $76.09
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$71.78 / $76.09 / $76.09
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$76.09 / $76.09 / $76.09
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$76.09 / $76.09 / $110.44
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$76.09 / $76.09 / $182.62
Well Sense
Facility/Professional
Professional
Modifier
Low / Median / High Price
$285.18 / $313.70 / $399.25