go back

Massachusetts rates for HCPCS 63704

Repair Myelomeningocele < 5 Cm Diameter

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,536.68 / $2,747.00 / $5,454.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,433.03 / $1,619.50 / $2,498.36
AllWays Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$818.35 / $3,414.00 / $7,231.00
AllWays Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,567.56 / $2,735.49 / $11,647.36
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,811.69 / $2,691.12 / $4,537.37
Fallon Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$300.00 / $2,606.16 / $8,090.00
Fallon Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,892.77 / $2,292.76 / $3,138.52
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,101.25 / $3,975.78 / $5,288.85
Mass General Brigham
Facility/Professional
Facility
Modifier
Low / Median / High Price
$55.00 / $3,372.00 / $14,345.91
Mass General Brigham
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,724.00 / $3,037.14 / $11,647.36
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$953.00 / $3,325.00 / $4,662.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,581.60 / $2,418.86 / $4,832.70