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Montana rates for HCPCS 35021

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, innominate, subclavian artery, by thoracic incision

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,403.72 / $6,433.26 / $6,433.26
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,948.61 / $1,948.61 / $1,948.61
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,430.07 / $1,948.61 / $1,948.61
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,948.61 / $2,296.44 / $2,321.91
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,199.21 / $1,698.92 / $2,594.90
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,801.83 / $2,261.12 / $3,421.58