Placement of extension prosthesis(es) distal to the common iliac artery(ies) or proximal to the renal artery(ies) for endovascular repair of infrarenal abdominal aortic or iliac aneurysm, false aneurysm, dissection, penetrating ulcer, including pre-procedure sizing and device selection, all nonselective catheterization(s), all associated radiological supervision and interpretation, and treatment zone angioplasty/stenting, when performed, per vessel treated (List separately in addition to code for primary procedure)
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,170.00 | $2,640.00 | $5,506.00 | |
BCBS
| Facility | $903.06 | $3,321.60 | $5,432.89 | |
Medica
| Facility | $325.17 | $595.91 | $4,349.00 | |
Medica
| Facility | 62 | $473.13 | $473.13 | $889.38 |
Medica
| Facility | AS | $75.70 | $75.70 | $142.30 |
United
| Facility | $1,424.00 | $3,269.00 | $6,416.00 |