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New Hampshire rates for HCPCS 49605

Repair of large omphalocele or gastroschisis; with or without prosthesis

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.00 / $8,521.04 / $17,288.50
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,389.35 / $4,999.18 / $6,367.34
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,476.90 / $9,132.04 / $17,364.89
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,765.29 / $8,510.94 / $13,675.29
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,889.51 / $8,971.23 / $14,628.82
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5,455.26 / $9,436.51 / $16,837.66
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$451.00 / $3,360.00 / $7,448.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5,218.92 / $7,627.59 / $14,427.99
Well Sense
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,879.03 / $4,266.93 / $5,430.64