Endovascular repair of infrarenal aorta by deployment of an aorto-aortic tube endograft including pre-procedure sizing and device selection, all nonselective catheterization(s), all associated radiological supervision and interpretation, all endograft extension(s) placed in the aorta from the level of the renal arteries to the aortic bifurcation, and all angioplasty/stenting performed from the level of the renal arteries to the aortic bifurcation; for rupture including temporary aortic and/or iliac balloon occlusion, when performed (eg, for aneurysm, pseudoaneurysm, dissection, penetrating ulcer, traumatic disruption)
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $3,548.13 | $4,265.80 | $23,988.33 | |
Kaiser Permanente
| Professional | $1,584.89 | $3,548.13 | $4,365.16 | |
Moda Health
| Facility | $2,344.23 | $3,388.44 | $23,988.33 | |
Pacific Source
| Facility | $2,818.38 | $3,311.31 | $3,630.78 | |
Providence
| Facility | $1,819.70 | $2,454.71 | $4,265.80 | |
United
| Facility | $2,454.71 | $10,232.93 | $37,153.52 |