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New Hampshire 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
$100.00 / $3,164.35 / $9,859.00
Aetna
Facility/Professional
Facility
Modifier
52
Low / Median / High Price
$1,582.18 / $3,491.81 / $3,491.81
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$24,135.11 / $43,638.29 / $63,311.75
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,155.96 / $2,155.96 / $2,155.96
Cigna
Facility/Professional
Facility
Modifier
52
Low / Median / High Price
$1,701.26 / $1,701.26 / $1,701.26
Cigna
Facility/Professional
Facility
Modifier
AS
Low / Median / High Price
$212.66 / $212.66 / $212.66
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$12,629.00 / $12,629.00 / $12,629.00