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Utah 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
$1,061.13 / $3,038.00 / $4,387.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,061.13 / $1,061.13 / $5,028.27
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,269.19 / $2,399.42 / $3,073.04
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$45.00 / $45.00 / $60.00
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,161.39 / $3,195.84 / $3,996.59
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,292.00 / $4,455.00 / $13,847.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,425.24 / $1,999.84 / $3,109.62