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New Hampshire rates for HCPCS 63621

Stereotactic radiosurgery (particle beam, gamma ray, or linear accelerator); each additional spinal lesion (List separately in addition to code for primary procedure)

Facilitymedian $8,710 · 10th–90th $851–$22,9090%20%40%10th90th$8,710$200.0$1.0K$5.0K$20.0K$100.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$851.14 / $851.14 / $851.14
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$10,964.78 / $15,488.17 / $22,908.68
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$107,151.93 / $114,815.36 / $131,825.67
Harvard Pilgrim
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$8,709.64 / $8,709.64 / $8,709.64
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$8,709.64 / $8,709.64 / $8,709.64
Well Sense
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$141.25 / $144.54 / $288.40