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North Carolina rates for HCPCS 34703

Endovascular repair of infrarenal aorta and/or iliac artery(ies) by deployment of an aorto-uni-iliac 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 iliac bifurcation, and all angioplasty/stenting performed from the level of the renal arteries to the iliac bifurcation; for other than rupture (eg, for aneurysm, pseudoaneurysm, dissection, penetrating ulcer)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,335.23 / $3,083.95 / $13,764.00
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,260.69 / $1,876.64 / $2,790.63
Medcost
Facility/Professional
Facility
Modifier
80
Low / Median / High Price
$375.33 / $375.33 / $623.16
Medcost
Facility/Professional
Facility
Modifier
AS
Low / Median / High Price
$214.32 / $262.73 / $436.22
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,064.00 / $3,906.00 / $6,388.00
Wellcare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$55.00 / $13,703.36 / $16,452.25
Wellcare
Facility/Professional
Facility
Modifier
AS
Low / Median / High Price
$300.88 / $324.35 / $625.21