go back

New Hampshire rates for HCPCS 22103

Partial excision of posterior vertebral component (eg, spinous process, lamina or facet) for intrinsic bony lesion, single vertebral segment; each additional segment (List separately in addition to code for primary procedure)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$512.86 / $2,398.83 / $11,481.54
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,495.41 / $5,495.41 / $5,495.41
Harvard Pilgrim
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7,413.10 / $7,413.10 / $7,413.10
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7,413.10 / $7,413.10 / $7,413.10
Well Sense
Facility/Professional
Facility
Modifier
Low / Median / High Price
$97.72 / $97.72 / $158.49