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Rhode Island 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
$3,715.35 / $3,981.07 / $3,981.07
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5,623.41 / $6,456.54 / $15,848.93
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,786.30 / $6,309.57 / $10,471.29
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$208.93 / $6,760.83 / $12,589.25
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,659.59 / $3,548.13 / $7,244.36
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,897.79 / $7,585.78 / $11,481.54