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North Dakota rates for HCPCS 27137

Revision of total hip arthroplasty; acetabular component only, with or without autograft or allograft

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,452.88 / $1,452.88 / $9,500.00
Aetna
Facility/Professional
Facility
Modifier
52
Low / Median / High Price
$726.44 / $726.44 / $726.44
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,452.88 / $1,976.60 / $2,657.13