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Minnesota 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
$5,248.07 / $5,248.07 / $5,248.07
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5,128.61 / $5,754.40 / $7,762.47
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$16,218.10 / $35,481.34 / $77,624.71
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8,511.38 / $12,882.50 / $20,417.38
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$13,489.63 / $19,498.45 / $45,708.82
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10,715.19 / $16,595.87 / $24,547.09
Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$14,791.08 / $18,620.87 / $36,307.81
Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10,000.00 / $13,803.84 / $20,892.96
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,388.44 / $8,128.31 / $12,022.64
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6,918.31 / $11,748.98 / $23,988.33
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,584.89 / $3,467.37 / $8,511.38
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6,918.31 / $11,481.54 / $21,877.62