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New Hampshire rates for HCPCS 54328

1-Stage Distal Hypospadias Repair (With Or Without Chordee Or Circumcision); With Extensive Dissection To Correct Chordee And Urethroplasty With Local Skin Flaps, Skin Graft Patch, And/Or Island Flap

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.00 / $3,786.69 / $9,859.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$946.78 / $1,625.95 / $3,786.69
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,302.10 / $3,669.21 / $6,000.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,087.61 / $1,775.32 / $2,751.97
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,191.58 / $1,923.73 / $3,072.90
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,040.54 / $2,064.21 / $3,427.64
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$11,155.00 / $11,155.00 / $11,155.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,285.82 / $1,648.36 / $3,224.68
Well Sense
Facility/Professional
Professional
Modifier
Low / Median / High Price
$734.99 / $808.49 / $1,028.99