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West Virginia rates for HCPCS 33853

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,400.00 / $1,903.96 / $1,903.96
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,903.96 / $2,019.35 / $2,272.17
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,927.26 / $2,206.40 / $2,403.90
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,136.80 / $2,136.80 / $2,136.80
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,068.61 / $2,068.61 / $2,068.61
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,731.29 / $2,711.68 / $11,964.80
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$765.00 / $765.00 / $765.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,530.03 / $2,321.26 / $3,374.56