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Arkansas rates for HCPCS 63704

Repair Myelomeningocele < 5 Cm Diameter

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,277.00 / $1,955.38 / $3,566.05
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,489.47 / $1,955.38 / $2,326.90
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,811.45 / $2,264.31 / $2,397.50
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,525.00 / $2,387.53 / $3,403.23
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$375.00 / $1,056.00 / $2,558.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,412.74 / $1,896.40 / $3,182.85