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New Hampshire rates for HCPCS 28202

Repair, tendon, flexor, foot; secondary with free graft, each tendon (includes obtaining graft)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,659.59 / $2,398.83 / $11,481.54
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8,912.51 / $10,000.00 / $18,197.01
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,089.30 / $2,089.30 / $2,089.30
Harvard Pilgrim
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9,549.93 / $9,549.93 / $9,549.93
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9,549.93 / $9,549.93 / $9,549.93
Well Sense
Facility/Professional
Facility
Modifier
Low / Median / High Price
$457.09 / $457.09 / $724.44