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New York rates for HCPCS 63704

Repair of myelomeningocele; less than 5 cm diameter

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,819.00 / $4,910.00 / $11,396.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,435.43 / $1,875.69 / $3,558.82
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,760.00 / $10,017.00 / $17,122.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,359.28 / $1,776.84 / $4,020.15
CDPHP
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,312.32 / $2,312.32 / $37,499.62
CDPHP
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,312.32 / $2,312.32 / $2,312.32
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,911.67 / $1,911.67 / $1,911.67
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,591.93 / $2,546.94 / $7,622.77
Emblem Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$332.00 / $2,060.00 / $4,738.07
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,840.46 / $2,645.66 / $4,064.21
Excellus BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,546.89 / $1,546.89 / $1,546.89
Excellus BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,271.42 / $1,921.62 / $3,490.31
MVP Health Care
Facility/Professional
Facility
Modifier
Low / Median / High Price
$555.00 / $597.00 / $49,110.00
MVP Health Care
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,659.38 / $2,539.39 / $7,177.79
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,749.00 / $4,194.00 / $9,603.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,437.33 / $2,300.58 / $5,584.72
Univera
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,921.62 / $1,921.62 / $6,731.77
Univera
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,345.45 / $2,121.10 / $4,182.46