| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $684.16 | $684.16 | $1,400.00 | |
CareSource
| Facility | $683.22 | $785.96 | $856.32 | |
Cigna
| Facility | $732.83 | $732.83 | $732.83 | |
Cigna
| Facility | AS | $70.95 | $70.95 | $70.95 |
Coronary artery bypass, using venous graft(s) and arterial graft(s); 4 venous grafts (List separately in addition to code for primary procedure)
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $684.16 | $684.16 | $1,400.00 | |
CareSource
| Facility | $683.22 | $785.96 | $856.32 | |
Cigna
| Facility | $732.83 | $732.83 | $732.83 | |
Cigna
| Facility | AS | $70.95 | $70.95 | $70.95 |