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Montana rates for HCPCS 33884

Placement of proximal extension prosthesis for endovascular repair of descending thoracic aorta (eg, aneurysm, pseudoaneurysm, dissection, penetrating ulcer, intramural hematoma, or traumatic disruption); each additional proximal extension (List separately in addition to code for primary procedure)

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,985.43 / $1,985.43 / $1,985.43
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$778.05 / $778.05 / $800.75
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$333.20 / $333.20 / $458.38
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$598.00 / $690.00 / $1,061.91