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Missouri 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
$1,740.36 / $4,470.00 / $12,154.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,680.35 / $2,008.62 / $2,090.27
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,114.00 / $4,286.00 / $10,043.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,254.22 / $1,556.36 / $2,770.74
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,196.09 / $2,286.23 / $3,961.74
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$55.00 / $2,413.00 / $11,043.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,574.92 / $2,671.24 / $12,087.04
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,367.00 / $2,693.00 / $10,500.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,558.68 / $2,428.40 / $4,313.56