go back

West 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
$1,412.54 / $2,344.23 / $2,344.23
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,187.76 / $2,398.83 / $2,691.53
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,290.87 / $2,290.87 / $2,884.03
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,570.40 / $2,570.40 / $2,570.40
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$34.67 / $3,630.78 / $3,630.78
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,819.70 / $3,548.13 / $13,803.84
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$758.58 / $758.58 / $758.58
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,862.09 / $2,630.27 / $3,981.07