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 | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $1,855.17 | $1,855.17 | $1,855.17 | |
Cigna
| Facility | $2,611.65 | $2,611.65 | $2,611.65 | |
Cigna
| Professional | $2,611.65 | $2,611.65 | $2,611.65 | |
Providence
| Facility | $2,611.65 | $2,611.65 | $2,611.65 | |
Providence
| Professional | $1,365.03 | $2,277.75 | $3,479.00 | |
United
| Professional | $2,245.84 | $2,600.69 | $4,353.45 |