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Pennsylvania rates for HCPCS 63704

Repair of myelomeningocele; less than 5 cm diameter

Facilitymedian $5,370 · 10th–90th $1,047$8,5110%10%20%10th90th$5,370Professionalmedian $1,698 · 10th–90th $1,445$2,9510%20%10th90th$1,698$10.0$50.0$200.0$1.0K$5.0K$20.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,047.13 / $5,754.40 / $8,511.38
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,445.44 / $1,698.24 / $2,884.03
Capital Blue Cross
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$20,417.38 / $21,379.62 / $57,543.99
Capital Blue Cross
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,398.83 / $2,398.83 / $2,570.40
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,348.96 / $1,995.26 / $3,311.31
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,995.26 / $2,691.53 / $3,467.37
Geisinger
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,513.56 / $2,089.30 / $2,818.38
Martin's Point
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$831.76 / $3,981.07 / $8,317.64
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,445.44 / $1,698.24 / $3,311.31
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,659.59 / $2,511.89 / $3,548.13
UPMC Health Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,479.11 / $1,479.11 / $1,621.81
UPMC Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,479.11 / $1,621.81 / $1,737.80
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$660.69 / $2,630.27 / $7,079.46
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,380.38 / $1,905.46 / $3,162.28