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Oklahoma rates for HCPCS 63704

Repair Myelomeningocele < 5 Cm Diameter

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,346.00 / $3,742.00 / $18,600.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,335.74 / $1,483.44 / $2,305.16
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,579.90 / $1,975.78 / $2,169.42
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$900.00 / $900.00 / $900.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,617.11 / $2,098.69 / $2,581.42
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$996.00 / $1,893.76 / $5,882.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,418.01 / $1,806.64 / $11,909.60
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$350.00 / $1,760.00 / $6,155.68
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,379.20 / $1,676.70 / $2,396.36