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Virginia 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
$3,235.94 / $6,456.54 / $14,791.08
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5,248.07 / $5,888.44 / $7,762.47
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$11,748.98 / $19,054.61 / $26,302.68
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5,495.41 / $7,244.36 / $10,232.93
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5,495.41 / $6,918.31 / $8,709.64
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5,011.87 / $7,413.10 / $13,489.63
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5,128.61 / $6,309.57 / $15,848.93
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6,918.31 / $9,120.11 / $13,489.63
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,754.40 / $7,762.47 / $11,748.98
Sentara
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,801.89 / $7,079.46 / $12,589.25
Sentara
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,801.89 / $7,079.46 / $12,589.25
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,698.24 / $3,467.37 / $7,079.46
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,570.88 / $7,079.46 / $11,748.98