go back

South Dakota 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
$2,206.71 / $2,206.71 / $2,206.71
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,169.87 / $2,206.71 / $7,839.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7,534.54 / $8,291.18 / $10,363.98
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,317.14 / $3,117.02 / $5,313.83
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,552.89 / $3,800.96 / $16,111.76
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,314.76 / $5,341.26 / $6,134.98
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,989.71 / $4,890.51 / $6,134.98
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
$2,374.44 / $3,652.98 / $5,053.26