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New Hampshire rates for HCPCS 22633

Arthrodesis, combined posterior or posterolateral technique with posterior interbody technique including laminectomy and/or discectomy sufficient to prepare interspace (other than for decompression), single interspace, lumbar;

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,187.76 / $4,466.84 / $20,892.96
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$63,095.73 / $77,624.71 / $87,096.36
Harvard Pilgrim
Facility/Professional
Facility
Modifier
Low / Median / High Price
$12,589.25 / $12,589.25 / $12,589.25
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$12,589.25 / $12,589.25 / $12,589.25
Well Sense
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,348.96 / $1,348.96 / $2,137.96
Well Sense
Facility/Professional
Facility
Modifier
62
Low / Median / High Price
$776.25 / $776.25 / $776.25