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South Carolina 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 / $9,120.11 / $16,595.87
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5,248.07 / $5,623.41 / $11,748.98
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,090.30 / $5,370.32 / $7,413.10
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,897.79 / $7,762.47 / $12,589.25
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,677.35 / $7,079.46 / $13,182.57
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.36 / $32.36 / $33.11
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,454.71 / $6,760.83 / $9,120.11
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5,128.61 / $6,606.93 / $12,022.64