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Pennsylvania 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
$511.36 / $1,985.43 / $2,074.12
Capital Blue Cross
Facility/Professional
Facility
Modifier
Low / Median / High Price
$13,531.00 / $27,840.00 / $46,480.74
Capital Blue Cross
Facility/Professional
Professional
Modifier
Low / Median / High Price
$341.52 / $513.85 / $781.86
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$579.54 / $579.54 / $620.91
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$497.45 / $694.37 / $1,985.43
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$721.80 / $875.20 / $944.40
UPMC Health Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$379.76 / $379.76 / $416.95
UPMC Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$360.27 / $387.36 / $416.95
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$375.22 / $490.99 / $803.14