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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
$2,398.83 / $9,772.37 / $17,378.01
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,466.84 / $5,128.61 / $9,772.37
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,890.45 / $10,964.78 / $16,982.44
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,466.84 / $9,549.93 / $14,125.38
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$691.83 / $7,413.10 / $13,182.57
Harvard Pilgrim
Facility/Professional
Facility
Modifier
Low / Median / High Price
$446.68 / $3,388.44 / $7,413.10
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5,128.61 / $7,413.10 / $11,748.98
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$446.68 / $3,388.44 / $7,413.10
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,897.79 / $7,413.10 / $13,182.57
Well Sense
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,548.13 / $4,897.79 / $6,025.60