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Tennessee 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
$2,398.83 / $2,691.53 / $7,585.78
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,412.54 / $1,737.80 / $3,090.30
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,258.93 / $2,344.23 / $4,897.79
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,621.81 / $2,187.76 / $3,388.44
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$794.33 / $794.33 / $794.33
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,513.56 / $2,137.96 / $3,235.94
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$54.95 / $30,902.95 / $30,902.95
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$18,620.87 / $18,620.87 / $18,620.87
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,258.93 / $2,630.27 / $4,786.30
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,380.38 / $2,187.76 / $3,388.44