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Texas 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
$1,000.00 / $3,715.35 / $12,882.50
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,137.96 / $2,511.89 / $3,715.35
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,905.46 / $2,238.72 / $3,235.94
Christus
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,949.84 / $1,949.84 / $1,949.84
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,238.72 / $3,019.95 / $4,786.30
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$54.95 / $56.23 / $38,018.94
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14,791.08 / $18,197.01 / $18,197.01
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,096.48 / $2,951.21 / $8,511.38
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,137.96 / $2,754.23 / $3,548.13
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.36 / $33.11 / $1,737.80
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,187.76 / $2,951.21 / $5,248.07
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,137.96 / $3,019.95 / $4,570.88
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$436.52 / $2,454.71 / $10,232.93
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,862.09 / $2,511.89 / $3,981.07
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,905.46 / $1,905.46 / $2,089.30