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New Jersey 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
$4,466.84 / $6,918.31 / $11,748.98
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5,248.07 / $5,888.44 / $10,715.19
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,677.35 / $8,317.64 / $19,054.61
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5,888.44 / $7,943.28 / $10,232.93
Horizon BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$109.65 / $109.65 / $109.65
Horizon BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,786.30 / $7,079.46 / $14,791.08
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,698.24 / $5,888.44 / $10,471.29
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,073.80 / $6,309.57 / $11,748.98