Statewide Reports

The statewide reports identify the range of provider charges and insurer prices for the most common procedures in New Hampshire.  These reports were created using data submitted by insurance carriers to the New Hampshire Comprehensive Health Care Information System (CHIS).  Prices are determined based on the "allowed amount" and include payments due from the insurance company, as well as any patient cost sharing (deductible, coinsurance, copayments).  The data included in these tables is very detailed and listed at the CPT (Current Procedural Terminology) code level with consideration for professional and institutional payments. 


There are two separate tables provided:

  • Statewide Summary.  This table includes data for all carriers and insurer commercial products, but separates insurance into group and individual.  

  • By Carrier and insurance type. This table provides charge and price ranges at the carrier level, with all specific commercial products consolidated.

    The tables include charge and price values at the 25th percentile, the median (or 50th percentile), and the 75th percentile.  These ranges were selected to minimize the influence of outlier cases on the data reported.  

    For each report, the following filters were applied to the data:

  • Medical claims with dates of service between January 2016 and December 2016 were selected;

  • Data were included only where there were more than 3 observations for the given procedure code, carrier, and insurance type;

  • Only outpatient and professional office claims are included;

  • Only claims for providers located in New Hampshire are included;

  • All prices and charges are for 1 unit of service

    The following carriers are included in these reports:

  • Anthem Blue Cross ("ANTHEM")

  • Harvard Pilgrim Health Care ("HPHC")

  • Tufts

  • OTHER" smaller carriers

    Charges and prices for procedures are identified separately for claims with modifiers  26 (professional component), TC (technical component), NU (new equipment), and RR (rental equipment).   Codes that do not list a modifier reflect the charge and price for all claims that reported no modifiers or reported other modifiers not noted above.

    Charges and prices are identified separately for professional (i.e. office based) claims and hospital claims.