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Massachusetts 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
$2,691.53 / $3,715.35 / $5,888.44
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5,248.07 / $5,888.44 / $15,848.93
AllWays Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$56.23 / $3,548.13 / $18,197.01
AllWays Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,786.30 / $8,128.31 / $39,810.72
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8,317.64 / $10,964.78 / $14,454.40
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,691.53 / $10,471.29 / $19,952.62
Fallon Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$302.00 / $6,918.31 / $9,772.37
Fallon Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6,025.60 / $7,413.10 / $11,748.98
Harvard Pilgrim
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,000.00 / $3,311.31 / $5,888.44
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5,495.41 / $9,772.37 / $14,454.40
Mass General Brigham
Facility/Professional
Facility
Modifier
Low / Median / High Price
$56.23 / $3,548.13 / $18,197.01
Mass General Brigham
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,786.30 / $8,128.31 / $39,810.72
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,000.00 / $3,311.31 / $5,754.40
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6,456.54 / $8,317.64 / $16,218.10