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West 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
$1,400.00 / $6,085.88 / $6,085.88
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5,388.62 / $6,085.88 / $6,759.77
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,108.34 / $7,022.64 / $7,651.27
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6,801.13 / $6,801.13 / $6,801.13
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,564.29 / $6,564.29 / $6,564.29
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5,450.76 / $8,501.42 / $30,104.83
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,534.09 / $6,884.78 / $9,598.20