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Iowa rates for HCPCS 63704

Repair Myelomeningocele < 5 Cm Diameter

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,277.00 / $6,066.00 / $11,100.08
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,431.01 / $2,267.46 / $2,418.12
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,896.01 / $3,565.07 / $4,413.60
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,555.27 / $2,326.67 / $4,927.54
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,174.48 / $3,491.89 / $4,732.75
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,644.65 / $3,085.47 / $11,909.60
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,790.00 / $3,565.07 / $4,591.35
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,226.09 / $3,510.37 / $4,591.35
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,126.00 / $5,847.00 / $7,856.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,569.90 / $2,392.21 / $4,485.42
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,600.84 / $3,292.20 / $3,873.10