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Missouri 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 / $4,897.79 / $8,511.38
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,089.30 / $2,630.27 / $3,801.89
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,238.72 / $4,677.35 / $10,000.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,398.83 / $2,884.03 / $4,466.84
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,862.09 / $2,238.72 / $3,311.31
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,621.81 / $3,162.28 / $5,888.44
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$54.95 / $3,090.30 / $11,748.98
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,089.30 / $3,715.35 / $15,488.17
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,380.38 / $2,818.38 / $10,471.29
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,089.30 / $3,467.37 / $5,623.41