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Montana rates for HCPCS 39503

Repair, neonatal diaphragmatic hernia, with or without chest tube insertion and with or without creation of ventral hernia

Facilitymedian $10,000 · 10th–90th $8,913–$10,9650%50%10th90th$10,000Professionalmedian $6,918 · 10th–90th $5,248–$15,8490%10%20%10th90th$6,918$100.0$500.0$2.0K$10.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$5,248.07 / $6,165.95 / $15,848.93
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$8,912.51 / $8,912.51 / $8,912.51
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$6,456.54 / $8,912.51 / $10,471.29
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$9,772.37 / $10,000.00 / $10,964.78
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$9,772.37 / $10,000.00 / $10,964.78
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5,370.32 / $7,413.10 / $10,964.78
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $6,456.54 / $12,882.50
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$6,918.31 / $6,918.31 / $6,918.31
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$8,128.31 / $10,232.93 / $15,848.93