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Montana rates for HCPCS 33853

Repair of hypoplastic or interrupted aortic arch using autogenous or prosthetic material; with cardiopulmonary bypass

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,778.28 / $2,398.83 / $5,370.32
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,818.38 / $2,818.38 / $2,818.38
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,137.96 / $2,137.96 / $2,818.38
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,090.30 / $3,162.28 / $3,467.37
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,090.30 / $3,162.28 / $3,467.37
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,187.76 / $3,019.95 / $3,548.13
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$79.43 / $1,737.80 / $3,548.13
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,754.23 / $3,162.28 / $5,011.87