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Tennessee 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
$2,398.83 / $2,691.53 / $7,585.78
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5,248.07 / $5,623.41 / $8,128.31
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,258.93 / $2,344.23 / $4,897.79
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6,165.95 / $8,511.38 / $13,803.84
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$794.33 / $794.33 / $794.33
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5,888.44 / $7,943.28 / $12,302.69
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$54.95 / $51,286.14 / $51,286.14
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$39,810.72 / $48,977.88 / $48,977.88
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,258.93 / $2,630.27 / $4,786.30
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5,623.41 / $7,762.47 / $12,022.64