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Virginia 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
$2,691.53 / $3,801.89 / $9,549.93
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,187.76 / $2,630.27 / $3,715.35
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,606.93 / $7,413.10 / $9,332.54
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,041.74 / $2,691.53 / $3,801.89
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,238.72 / $2,754.23 / $3,801.89
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,238.72 / $2,951.21 / $4,265.80
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,862.09 / $2,238.72 / $2,754.23
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,162.28 / $4,073.80 / $5,128.61
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,137.96 / $3,311.31 / $4,897.79
Sentara
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,949.84 / $2,951.21 / $10,000.00
Sentara
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,949.84 / $2,951.21 / $10,000.00
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,698.24 / $3,467.37 / $7,079.46
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,949.84 / $3,090.30 / $5,011.87