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Arizona 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
$1,671.00 / $3,617.00 / $6,329.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5,062.51 / $5,607.54 / $15,751.81
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,763.75 / $6,598.50 / $10,860.55
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,130.08 / $5,506.78 / $6,883.47
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5,164.87 / $6,907.16 / $12,998.21
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,943.00 / $5,809.10 / $10,555.85
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5,208.66 / $6,779.97 / $41,111.36
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,424.00 / $3,269.00 / $14,572.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5,208.66 / $6,418.83 / $11,462.45