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Montana rates for HCPCS 35005

Direct repair of aneurysm, pseudoaneurysm, or excision (partial or total) and graft insertion, with or without patch graft; for aneurysm, pseudoaneurysm, and associated occlusive disease, vertebral artery

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,116.49 / $5,024.92 / $5,024.92
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,537.44 / $1,537.44 / $1,537.44
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,242.11 / $1,537.44 / $1,537.44
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,537.44 / $1,989.00 / $2,156.19
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$945.59 / $1,339.61 / $2,046.10
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,213.71 / $1,213.71 / $1,213.71
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,501.77 / $1,818.88 / $2,691.75