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Indiana rates for HCPCS 34847

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,380.38 / $4,897.79 / $4,897.79
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,096.48 / $2,344.23 / $3,019.95
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10,232.93 / $25,703.96 / $35,481.34
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,019.95 / $3,981.07 / $6,165.95
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,949.84 / $2,089.30 / $2,290.87
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,949.84 / $2,884.03 / $14,454.40
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,412.54 / $5,754.40 / $12,022.64
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,479.11 / $2,187.76 / $3,981.07