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West Virginia 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
$1,400.00 / $1,696.99 / $1,696.99
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,696.99 / $1,817.48 / $2,128.15
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,728.67 / $1,728.67 / $2,109.92
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,875.49 / $1,875.49 / $1,875.49
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,859.50 / $1,859.50 / $1,859.50
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,328.95 / $2,345.21 / $7,751.86
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$765.00 / $765.00 / $765.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,059.79 / $1,854.64 / $2,930.83