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New Mexico 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
$5,495.41 / $8,709.64 / $8,912.51
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5,128.61 / $5,754.40 / $13,803.84
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5,128.61 / $7,079.46 / $10,000.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,786.30 / $8,912.51 / $11,481.54
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.36 / $33.11 / $8,511.38
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,025.60 / $8,317.64 / $14,125.38
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,786.30 / $8,511.38 / $11,481.54
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,090.30 / $5,128.61 / $19,498.45
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6,309.57 / $8,709.64 / $14,125.38