go back

Alaska rates for HCPCS 39503

Repair, neonatal diaphragmatic hernia, with or without chest tube insertion and with or without creation of ventral hernia

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9,772.37 / $14,125.38 / $17,378.01
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5,248.07 / $7,079.46 / $28,840.32
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19,952.62 / $19,952.62 / $19,952.62
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,760.83 / $8,317.64 / $40,738.03
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$13,489.63 / $17,378.01 / $38,904.51
Premera BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$22,908.68 / $22,908.68 / $35,481.34
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8,317.64 / $28,840.32 / $41,686.94
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.26 / $5,754.40 / $19,952.62
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12,022.64 / $15,848.93 / $36,307.81