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New Hampshire rates for HCPCS Q4204

Xwrap 1 Sq Cm

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,774.77 / $3,774.77 / $4,529.72
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,692.14 / $3,692.14 / $4,430.57
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,692.14 / $3,692.14 / $3,692.14
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,483.15 / $3,692.14 / $3,692.14
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,692.14 / $3,692.14 / $3,692.14
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,692.14 / $3,692.14 / $5,358.77
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,287.24 / $3,692.14 / $8,861.14
Well Sense
Facility/Professional
Professional
Modifier
Low / Median / High Price
$459.00 / $504.90 / $642.60