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Michigan 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
$2,951.21 / $4,897.79 / $4,897.79
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,137.96 / $2,630.27 / $3,981.07
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$630.96 / $630.96 / $1,995.26
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$630.96 / $3,162.28 / $3,162.28
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,949.84 / $3,090.30 / $3,467.37
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,951.21 / $4,897.79 / $7,413.10
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,137.96 / $2,754.23 / $3,715.35
Priority Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,949.84 / $2,754.23 / $3,890.45
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,698.24 / $3,890.45 / $6,025.60
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,511.89 / $3,090.30 / $3,981.07