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Wyoming rates for HCPCS 63704

Repair of myelomeningocele; less than 5 cm diameter

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,479.11 / $1,621.81 / $2,951.21
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,388.44 / $5,495.41 / $6,606.93
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,949.84 / $2,818.38 / $4,168.69
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,288.25 / $1,288.25 / $3,090.30
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,737.80 / $3,019.95 / $6,456.54