go back

New Hampshire rates for HCPCS 35121

Direct repair of aneurysm, pseudoaneurysm, or excision (partial or total) and graft insertion, with or without patch graft; for aneurysm, pseudoaneurysm, and associated occlusive disease, hepatic, celiac, renal, or mesenteric artery

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.00 / $6,329.96 / $9,859.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,079.73 / $1,861.53 / $1,861.53
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
$1,633.95 / $2,942.75 / $4,692.82
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,338.19 / $3,690.15 / $4,556.01
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,718.88 / $3,281.57 / $5,659.89
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
$2,082.90 / $2,964.98 / $6,006.79
Well Sense
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,219.93 / $1,341.92 / $1,707.90