go back

South Dakota rates for HCPCS 34845

Endovascular repair of visceral aorta and infrarenal abdominal aorta (eg, aneurysm, pseudoaneurysm, dissection, penetrating ulcer, intramural hematoma, or traumatic disruption) with a fenestrated visceral aortic endograft and concomitant unibody or modular infrarenal aortic endograft and all associated radiological supervision and interpretation, including target zone angioplasty, when performed; including one visceral artery endoprosthesis (superior mesenteric, celiac or renal artery)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,968.35 / $1,968.35 / $1,968.35
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,810.78 / $1,968.35 / $1,968.35
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5,876.40 / $6,466.53 / $8,083.16
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,117.14 / $2,601.19 / $4,739.79
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,303.63 / $3,654.77 / $13,445.28
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,956.68 / $4,457.28 / $5,441.50
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,329.45 / $4,487.97 / $5,441.50
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,000.00 / $2,000.00 / $2,000.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,303.63 / $2,519.14 / $3,818.42