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New Hampshire rates for HCPCS 53454

Periurethral transperineal adjustable balloon continence device; percutaneous adjustment of balloon(s) fluid volume

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.00 / $1,749.77 / $9,859.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$23.57 / $31.28 / $31.28
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,223.09 / $1,359.00 / $3,300.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$53.99 / $88.55 / $134.90
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$44.75 / $63.26 / $162.93
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$55.17 / $109.45 / $181.74
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
$30.54 / $44.19 / $72.94
Well Sense
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,500.00 / $2,750.00 / $3,500.00