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Arizona rates for HCPCS 27134

Revision of total hip arthroplasty; both components, with or without autograft or allograft

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,114.00 / $6,060.00 / $18,566.00
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,763.75 / $6,855.80 / $10,860.55
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,812.50 / $2,435.77 / $16,841.00
Medica
Facility/Professional
Facility
Modifier
52
Low / Median / High Price
$3,825.93 / $3,825.93 / $6,958.71
Medica
Facility/Professional
Facility
Modifier
AS
Low / Median / High Price
$478.24 / $478.24 / $869.84
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,560.00 / $10,420.00 / $22,633.00