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Washington, DC rates for HCPCS 63704

Repair Myelomeningocele < 5 Cm Diameter

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,017.00 / $1,747.50 / $7,727.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,747.50 / $1,747.50 / $1,747.50
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,740.00 / $1,876.36 / $2,045.23
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,591.93 / $2,178.69 / $4,408.05
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,872.86 / $3,896.54 / $3,896.54
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$645.00 / $1,319.00 / $16,382.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,266.58 / $2,178.69 / $4,612.04