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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
$1,000.00 / $7,838.38 / $7,838.38
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5,429.54 / $5,622.09 / $9,601.23
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5,185.64 / $7,087.93 / $10,097.41
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6,112.24 / $8,880.67 / $11,410.63
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.34 / $1,693.55 / $9,098.84
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,293.27 / $6,736.88 / $8,392.41
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6,907.16 / $9,009.34 / $11,410.63
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,085.00 / $4,262.00 / $17,636.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6,986.02 / $8,895.62 / $14,029.18