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New Hampshire rates for HCPCS 22904

Radical resection of tumor (eg, sarcoma), soft tissue of abdominal wall; less than 5 cm

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,398.83 / $2,398.83 / $9,772.37
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$954.99 / $1,096.48 / $1,318.26
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,467.37 / $4,677.35 / $6,309.57
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$977.24 / $1,995.26 / $2,818.38
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$316.23 / $2,187.76 / $3,162.28
Harvard Pilgrim
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8,709.64 / $8,709.64 / $8,709.64
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,122.02 / $1,819.70 / $3,090.30
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8,709.64 / $8,709.64 / $8,709.64
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,202.26 / $1,819.70 / $3,630.78