Endovascular repair of iliac artery, not associated with placement of an aorto-iliac artery endograft at the same session, by deployment of an iliac branched endograft, including pre-procedure sizing and device selection, all ipsilateral selective iliac artery catheterization(s), all associated radiological supervision and interpretation, and all endograft extension(s) proximally to the aortic bifurcation and distally in the internal iliac, external iliac, and common femoral artery(ies), and treatment zone angioplasty/stenting, when performed, for other than rupture (eg, for aneurysm, pseudoaneurysm, dissection, arteriovenous malformation, penetrating ulcer), unilateral
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $2,593.48 | $7,920.26 | $13,496.00 | |
Kaiser Permanente
| Professional | $1,870.36 | $2,634.70 | $2,999.26 | |
Moda Health
| Facility | $1,142.57 | $2,247.26 | $3,378.75 | |
Pacific Source
| Facility | $1,586.26 | $2,278.42 | $2,424.06 | |
Providence
| Facility | $1,142.57 | $2,450.77 | $3,378.75 | |
United
| Facility | $2,364.00 | $7,664.00 | $36,803.00 |