go back

Vermont rates for HCPCS 63704

Repair Myelomeningocele < 5 Cm Diameter

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,686.78 / $1,686.78 / $1,875.69
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,962.11 / $2,213.05 / $3,576.38
MVP Health Care
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,676.88 / $2,213.05 / $3,576.38
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,845.16 / $2,025.71 / $3,626.01