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Pennsylvania 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
Facility
Modifier
Low / Median / High Price
$1,047.13 / $5,754.40 / $8,511.38
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$977.24 / $1,174.90 / $3,090.30
Capital Blue Cross
Facility/Professional
Facility
Modifier
Low / Median / High Price
$20,417.38 / $21,379.62 / $57,543.99
Capital Blue Cross
Facility/Professional
Professional
Modifier
Low / Median / High Price
$870.96 / $1,479.11 / $1,949.84
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$977.24 / $1,318.26 / $1,995.26
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,412.54 / $1,412.54 / $1,621.81
Geisinger
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,148.15 / $1,318.26 / $3,388.44
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,023.29 / $4,265.80 / $8,317.64
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,047.13 / $1,318.26 / $3,090.30
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,258.93 / $1,318.26 / $2,398.83
UPMC Health Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$954.99 / $1,230.27 / $1,230.27
UPMC Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$478.63 / $977.24 / $1,230.27
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$660.69 / $2,570.40 / $6,760.83
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$933.25 / $1,288.25 / $2,041.74