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West Virginia 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
$1,400.00 / $2,115.55 / $2,115.55
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,115.55 / $2,422.71 / $2,696.42
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,171.05 / $2,171.05 / $2,649.77
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,355.35 / $2,355.35 / $2,355.35
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,478.71 / $2,478.71 / $2,478.71
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,869.37 / $3,078.97 / $10,904.33
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,118.70 / $1,957.72 / $3,101.62