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Missouri rates for HCPCS 33504

Repair of anomalous coronary artery from pulmonary artery origin; by graft, with cardiopulmonary bypass

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,778.28 / $4,897.79 / $8,511.38
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,348.96 / $1,778.28 / $2,511.89
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,238.72 / $4,677.35 / $8,912.51
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,548.82 / $1,905.46 / $3,019.95
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,318.26 / $1,548.82 / $2,290.87
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,318.26 / $2,089.30 / $3,890.45
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$54.95 / $2,511.89 / $11,748.98
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,412.54 / $2,398.83 / $18,620.87
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,380.38 / $2,818.38 / $10,471.29
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,412.54 / $2,187.76 / $3,715.35