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Maine 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
Professional
Modifier
Low / Median / High Price
$1,479.11 / $2,691.53 / $4,677.35
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,513.56 / $3,019.95 / $4,570.88
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,691.53 / $2,951.21 / $4,570.88
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,454.71 / $2,884.03 / $3,801.89
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,398.83 / $3,311.31 / $6,606.93
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,398.83 / $3,235.94 / $4,168.69