go back

Idaho rates for HCPCS 34842

Endovascular repair of visceral aorta (eg, aneurysm, pseudoaneurysm, dissection, penetrating ulcer, intramural hematoma, or traumatic disruption) by deployment of a fenestrated visceral aortic endograft and all associated radiological supervision and interpretation, including target zone angioplasty, when performed; including two visceral artery endoprostheses (superior mesenteric, celiac and/or renal artery[s])

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,500.00 / $4,500.00 / $5,519.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,855.17 / $2,261.06 / $5,028.27
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,127.36 / $2,604.17 / $2,907.39
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,548.45 / $2,814.00 / $6,436.19
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,829.98 / $1,829.98 / $1,829.98
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.00 / $1,266.91 / $3,500.00
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,310.51 / $3,310.51 / $3,357.46
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,700.00 / $15,298.00 / $26,104.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,558.68 / $2,228.91 / $3,527.48