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New Mexico 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
$1,000.00 / $7,838.38 / $7,838.38
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,091.79 / $2,094.96 / $3,706.94
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,210.85 / $3,229.78 / $3,559.22
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.00 / $1,970.87 / $4,128.84
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,372.82 / $3,229.78 / $3,559.22
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,085.00 / $4,262.00 / $17,636.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,149.92 / $2,627.69 / $3,645.08