go back

Nebraska 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
$5,026.97 / $10,431.19 / $20,928.72
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5,026.97 / $5,026.97 / $30,065.00
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$14,877.26 / $20,162.50 / $37,850.17
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,833.51 / $8,238.94 / $10,985.25
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10,072.51 / $12,517.30 / $16,914.66
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,406.00 / $8,797.21 / $12,964.30
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6,986.53 / $12,718.26 / $41,111.36
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9,665.00 / $12,465.70 / $17,805.34
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8,902.90 / $12,465.70 / $16,914.66
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.00 / $3,368.50 / $14,185.60
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,054.00 / $4,317.00 / $13,909.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6,986.53 / $12,524.15 / $15,639.09