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Pennsylvania rates for HCPCS 35022

Direct repair of aneurysm, pseudoaneurysm, or excision (partial or total) and graft insertion, with or without patch graft; for ruptured aneurysm, innominate, subclavian artery, by thoracic incision

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,020.00 / $3,839.00 / $8,427.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,365.69 / $1,579.14 / $1,980.66
Capital Blue Cross
Facility/Professional
Facility
Modifier
Low / Median / High Price
$13,531.00 / $27,840.00 / $46,480.74
Capital Blue Cross
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,249.89 / $1,870.70 / $2,699.26
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,393.16 / $1,810.26 / $2,878.61
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,171.26 / $2,171.26 / $2,268.48
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,013.00 / $4,761.00 / $8,427.00
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,361.27 / $1,715.32 / $5,958.00
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.00 / $2,171.80 / $3,546.70
Priority Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,409.57 / $1,836.21 / $2,878.61
UPMC Health Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,389.50 / $1,389.50 / $1,636.48
UPMC Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,331.05 / $1,412.58 / $1,636.48
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$656.00 / $2,391.00 / $6,322.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,333.73 / $1,779.95 / $2,908.92