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New Hampshire rates for HCPCS 35013

Direct repair of aneurysm, pseudoaneurysm, or excision (partial or total) and graft insertion, with or without patch graft; for ruptured aneurysm, axillary-brachial artery, by arm incision

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.00 / $4,754.35 / $9,859.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$821.15 / $1,407.73 / $1,407.73
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,769.10 / $5,299.00 / $8,600.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,308.50 / $2,216.88 / $3,522.65
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,756.61 / $2,981.49 / $3,681.06
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,290.27 / $2,463.29 / $4,248.57
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7,448.00 / $7,448.00 / $7,448.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,323.04 / $2,357.30 / $7,059.26
Well Sense
Facility/Professional
Professional
Modifier
Low / Median / High Price
$980.52 / $1,078.57 / $1,372.73