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Montana rates for HCPCS 33783

Aortic root translocation with ventricular septal defect and pulmonary stenosis repair (ie, Nikaidoh procedure); with reimplantation of 1 or both coronary ostia

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,880.90 / $17,750.90 / $17,750.90
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,381.56 / $5,381.56 / $5,381.56
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,376.14 / $5,381.56 / $5,381.56
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,381.56 / $6,401.20 / $6,602.67
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,302.61 / $4,678.78 / $7,146.30
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5,022.47 / $6,076.80 / $9,439.61