go back

Louisiana rates for HCPCS 63704

Repair of myelomeningocele; less than 5 cm diameter

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$933.25 / $2,691.53 / $4,365.16
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,380.38 / $1,862.09 / $2,951.21
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,309.57 / $10,715.19 / $14,791.08
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,737.80 / $2,137.96 / $2,754.23
Christus
Facility/Professional
Facility
Modifier
Low / Median / High Price
$39.81 / $39.81 / $1,621.81
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$398.11 / $398.11 / $398.11
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,380.38 / $2,187.76 / $2,951.21
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$389.05 / $1,230.27 / $6,165.95
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,380.38 / $1,819.70 / $3,311.31