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 four or more visceral artery endoprostheses (superior mesenteric, celiac and/or renal artery[s])
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $1,117.19 | $3,000.84 | $5,851.63 | |
Anthem BCBS
| Professional | $3,045.41 | $3,313.19 | $3,313.19 | |
Cigna
| Professional | $2,325.50 | $3,000.84 | $4,379.49 | |
Harvard Pilgrim
| Professional | $2,358.81 | $2,625.71 | $4,085.60 | |
Martin's Point
| Professional | $1,117.19 | $3,000.84 | $5,851.63 | |
United
| Professional | $2,479.90 | $4,017.63 | $5,309.24 |