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New Hampshire rates for HCPCS Q4254

Novafix dl per sq cm

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$355.88 / $355.88 / $427.06
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$355.88 / $355.88 / $427.05
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$355.88 / $355.88 / $355.88
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$408.00 / $408.00 / $408.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$408.00 / $408.00 / $408.00
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$355.88 / $355.88 / $516.52
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$408.00 / $480.00 / $480.00
Well Sense
Facility/Professional
Professional
Modifier
Low / Median / High Price
$408.00 / $448.80 / $571.20