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Minnesota rates for HCPCS 63704

Repair Myelomeningocele < 5 Cm Diameter

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,532.00 / $1,532.00 / $1,532.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,483.44 / $1,570.66 / $2,418.12
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$370.96 / $830.40 / $12,050.40
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,949.23 / $4,745.70 / $6,032.77
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,786.55 / $5,372.57 / $12,924.44
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,835.23 / $4,516.45 / $6,707.62
Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,442.32 / $4,911.82 / $10,176.73
Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,566.92 / $4,039.32 / $6,151.28
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,646.00 / $2,589.08 / $4,251.49
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,775.72 / $3,064.52 / $6,505.51
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,720.00 / $3,500.00 / $8,152.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,749.96 / $2,930.80 / $6,189.41