go back

New Hampshire rates for HCPCS V5264

Ear Mold/Insert Not Disposable Any Type (Not Covered By Medicare. Statute Reference: 1862a7)

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$45.02 / $49.28 / $57.45
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$40.00 / $49.00 / $70.70
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14.25 / $14.25 / $5,100.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$51.11 / $52.13 / $52.77