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New Hampshire rates for HCPCS 34843

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 three visceral artery endoprostheses (superior mesenteric, celiac and/or renal artery[s])

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.00 / $100.00 / $9,859.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,091.79 / $1,091.79 / $1,091.79
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8,512.20 / $9,458.00 / $17,400.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,781.20 / $2,781.20 / $2,781.20
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,937.99 / $4,420.56 / $5,457.79
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,123.78 / $4,054.58 / $6,993.14
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7,448.00 / $7,448.00 / $7,448.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,412.37 / $3,324.72 / $7,720.98
Well Sense
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,583.83 / $1,742.21 / $2,217.36