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New Hampshire rates for MS-DRG 495

Local excision and removal of internal fixation devices except hip and femur with MCC

Insurance Carrier
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$24,968.77 / $39,957.39 / $76,291.39
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$30,166.00 / $39,056.04 / $74,825.46
Harvard Pilgrim
Facility/Professional
Facility
Modifier
Low / Median / High Price
$33,319.64 / $52,416.74 / $77,006.24
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$42,688.99 / $42,688.99 / $74,290.59