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Nationwide rates for HCPCS 0495T

Initiation and monitoring marginal (extended) cadaver donor lung(s) organ perfusion system by physician or qualified health care professional, including physiological and laboratory assessment (eg, pulmonary artery flow, pulmonary artery pressure, left atrial pressure, pulmonary vascular resistance, mean/peak and plateau airway pressure, dynamic compliance and perfusate gas analysis), including bronchoscopy and X ray when performed; first two hours in sterile field

Insurance Carrier	Facility/Professional	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $1,000.00 / $4,897.79 / $11,481.54	Facility	$1,000.00	$4,897.79	$11,481.54
Aetna Facility/Professional Professional Modifier Low / Median / High Price $223.87 / $316.23 / $407.38	Professional	$223.87	$316.23	$407.38
BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,862.09 / $5,248.07 / $15,135.61	Facility	$1,862.09	$5,248.07	$15,135.61
BCBS Facility/Professional Professional Modifier Low / Median / High Price $295.12 / $354.81 / $645.65	Professional	$295.12	$354.81	$645.65
Cigna Facility/Professional Facility Modifier Low / Median / High Price $398.11 / $537.03 / $18,197.01	Facility	$398.11	$537.03	$18,197.01
Cigna Facility/Professional Professional Modifier Low / Median / High Price $416.87 / $1,513.56 / $1,513.56	Professional	$416.87	$1,513.56	$1,513.56
United Facility/Professional Facility Modifier Low / Median / High Price $812.83 / $3,162.28 / $10,232.93	Facility	$812.83	$3,162.28	$10,232.93
United Facility/Professional Professional Modifier Low / Median / High Price $295.12 / $426.58 / $758.58	Professional	$295.12	$426.58	$758.58

Nationwide rates for HCPCS 0495T

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