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Utah rates for HCPCS 63704

Repair of myelomeningocele; less than 5 cm diameter

Facilitymedian $4,169 · 10th–90th $2,291–$6,0260%20%10th90th$4,169Professionalmedian $2,291 · 10th–90th $1,479–$8,7100%10%10th90th$2,291$50.0$200.0$1.0K$5.0K

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
$2,290.87 / $3,388.44 / $6,025.60
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,548.82 / $2,290.87 / $9,772.37
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,412.54 / $2,238.72 / $3,890.45
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $4,570.88
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,570.40 / $3,235.94 / $6,456.54
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,659.59 / $3,890.45 / $5,128.61
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,513.56 / $2,818.38 / $3,630.78
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,288.25 / $4,466.84 / $13,803.84
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,348.96 / $1,659.59 / $2,754.23