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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
$100.00 / $2,485.29 / $21,126.00
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$54,000.00 / $75,000.00 / $83,200.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,059.71 / $2,059.71 / $2,059.71
Cigna
Facility/Professional
Facility
Modifier
62
Low / Median / High Price
$1,274.33 / $1,274.33 / $1,274.33
Cigna
Facility/Professional
Facility
Modifier
AS
Low / Median / High Price
$203.90 / $203.90 / $203.90
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$12,629.00 / $12,629.00 / $12,629.00