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Idaho 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
$4,466.84 / $5,495.41 / $5,495.41
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5,011.87 / $5,754.40 / $8,128.31
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$20,892.96 / $23,442.29 / $28,183.83
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9,120.11 / $10,715.19 / $10,964.78
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6,918.31 / $8,912.51 / $10,715.19
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,248.07 / $7,413.10 / $12,302.69
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6,025.60 / $9,332.54 / $11,748.98
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.36 / $32.36 / $33.11
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7,943.28 / $9,120.11 / $10,715.19
Select Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,786.30 / $4,786.30 / $11,220.18
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,715.35 / $15,488.17 / $26,302.68
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5,495.41 / $8,317.64 / $12,302.69