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Indiana 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
$2,290.87 / $3,090.30 / $4,897.79
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,137.96 / $2,511.89 / $3,801.89
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8,317.64 / $19,952.62 / $27,542.29
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,949.84 / $2,754.23 / $4,365.16
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,949.84 / $2,187.76 / $2,290.87
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,187.76 / $3,388.44 / $5,754.40
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,412.54 / $5,754.40 / $12,022.64
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,041.74 / $2,754.23 / $4,466.84