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New Hampshire rates for HCPCS 0275T

Percutaneous laminotomy/laminectomy (interlaminar approach) for decompression of neural elements, (with or without ligamentous resection, discectomy, facetectomy and/or foraminotomy), any method, under indirect image guidance (eg, fluoroscopic, CT), single or multiple levels, unilateral or bilateral; lumbar

Insurance Carrier
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8,512.20 / $9,458.00 / $17,400.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,113.02 / $1,113.02 / $1,113.02
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$993.29 / $1,371.69 / $2,594.61
Well Sense
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,500.00 / $3,000.00 / $4,410.00