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Idaho rates for HCPCS 35103

Direct repair of aneurysm, pseudoaneurysm, or excision (partial or total) and graft insertion, with or without patch graft; for ruptured aneurysm, abdominal aorta involving iliac vessels (common, hypogastric, external)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,466.84 / $5,495.41 / $5,495.41
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,290.87 / $2,818.38 / $6,606.93
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8,128.31 / $9,120.11 / $12,882.50
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,388.44 / $3,981.07 / $4,073.80
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,951.21 / $3,715.35 / $4,365.16
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,630.27 / $4,265.80 / $8,317.64
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,235.94 / $3,715.35 / $4,466.84
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.36 / $32.36 / $33.11
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,073.80 / $4,365.16 / $4,570.88
Select Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,778.28 / $1,778.28 / $4,265.80
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,715.35 / $15,488.17 / $26,302.68
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,344.23 / $3,162.28 / $4,786.30