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Missouri 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
$2,511.89 / $5,623.41 / $8,511.38
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5,248.07 / $5,754.40 / $13,803.84
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,238.72 / $4,786.30 / $10,000.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5,495.41 / $7,079.46 / $10,715.19
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5,248.07 / $6,165.95 / $8,912.51
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$602.56 / $7,943.28 / $13,489.63
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$54.95 / $5,623.41 / $17,378.01
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5,495.41 / $7,943.28 / $40,738.03
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,380.38 / $2,818.38 / $10,471.29
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5,495.41 / $6,760.83 / $11,220.18