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New Hampshire 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
$2,398.83 / $9,772.37 / $20,892.96
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5,370.32 / $5,888.44 / $15,848.93
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10,000.00 / $18,197.01 / $28,183.83
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5,370.32 / $11,748.98 / $16,982.44
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$549.54 / $11,748.98 / $16,595.87
Harvard Pilgrim
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7,413.10 / $7,413.10 / $7,413.10
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6,025.60 / $9,772.37 / $16,595.87
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7,413.10 / $7,413.10 / $7,413.10
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6,165.95 / $9,772.37 / $16,218.10