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Connecticut rates for HCPCS 63704

Repair Myelomeningocele < 5 Cm Diameter

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,418.12 / $5,194.00 / $10,492.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,376.40 / $2,054.76 / $4,132.51
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$12,098.00 / $19,753.83 / $26,880.01
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,536.96 / $2,888.15 / $3,990.38
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$843.00 / $843.00 / $843.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,265.00 / $2,864.30 / $4,614.18
ConnectiCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,346.67 / $2,466.00 / $2,518.00
ConnectiCare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,486.17 / $2,211.10 / $2,849.62
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,242.00 / $4,647.00 / $9,973.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,476.13 / $2,767.74 / $5,055.02