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Maine 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
Professional
Modifier
Low / Median / High Price
$5,495.41 / $5,888.44 / $15,848.93
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$20,892.96 / $22,387.21 / $29,512.09
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5,128.61 / $8,709.64 / $11,748.98
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6,309.57 / $7,943.28 / $12,302.69
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6,606.93 / $8,128.31 / $11,481.54
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5,495.41 / $7,413.10 / $15,848.93
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5,754.40 / $8,511.38 / $11,748.98