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North Dakota rates for HCPCS 63704

Repair of myelomeningocele; less than 5 cm diameter

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,548.82 / $1,584.89 / $8,511.38
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,412.54 / $1,548.82 / $3,890.45
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,019.95 / $3,715.35 / $4,365.16
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,659.59 / $2,951.21 / $4,897.79
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,584.89 / $2,089.30 / $2,951.21
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,513.56 / $2,630.27 / $12,022.64
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,819.70 / $2,041.74 / $2,041.74
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,479.11 / $2,754.23 / $3,981.07