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Nebraska 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
$4,241.22 / $12,036.14 / $27,005.65
Aetna
Facility/Professional
Facility
Modifier
52
Low / Median / High Price
$856.34 / $856.34 / $856.34
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$12,999.34 / $17,097.68 / $33,072.44
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,712.68 / $3,142.50 / $9,815.00
Medica
Facility/Professional
Facility
Modifier
52
Low / Median / High Price
$3,825.93 / $6,958.71 / $6,958.71
Medica
Facility/Professional
Facility
Modifier
AS
Low / Median / High Price
$478.24 / $869.84 / $869.84
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,229.80 / $4,274.56 / $5,873.24
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8,148.00 / $9,696.00 / $15,622.00