| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $3,162.28 | $4,570.88 | $6,025.60 | |
U of Utah Health Plan
| Professional | $4,365.16 | $5,128.61 | $13,803.84 | |
United
| Facility | $2,290.87 | $5,128.61 | $13,803.84 |
Transverse aortic arch graft, with cardiopulmonary bypass, with profound hypothermia, total circulatory arrest and isolated cerebral perfusion with reimplantation of arch vessel(s) (eg, island pedicle or individual arch vessel reimplantation)
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $3,162.28 | $4,570.88 | $6,025.60 | |
U of Utah Health Plan
| Professional | $4,365.16 | $5,128.61 | $13,803.84 | |
United
| Facility | $2,290.87 | $5,128.61 | $13,803.84 |