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New Hampshire rates for HCPCS 63744

Replacement, irrigation or revision of lumbosubarachnoid shunt

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.00 / $2,185.48 / $9,859.00
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,769.10 / $5,299.00 / $8,600.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$818.36 / $2,000.36 / $2,070.38
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$11,155.00 / $11,155.00 / $11,155.00