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New Hampshire rates for HCPCS V2755

U-V Lens Per Lens (Special Coverage Instructions Apply. See Mcm: 2130b)

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.23 / $12.12 / $16.89
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$25.96 / $26.58 / $26.58
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9.57 / $9.57 / $9.57
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$21.67 / $21.67 / $21.67
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9.19 / $13.26 / $21.67
Well Sense
Facility/Professional
Professional
Modifier
Low / Median / High Price
$17.98 / $21.58 / $34.04