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Montana rates for HCPCS 35121

Direct repair of aneurysm, pseudoaneurysm, or excision (partial or total) and graft insertion, with or without patch graft; for aneurysm, pseudoaneurysm, and associated occlusive disease, hepatic, celiac, renal, or mesenteric artery

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,548.82 / $2,089.30 / $5,623.41
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,454.71 / $2,454.71 / $2,454.71
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,454.71 / $2,454.71 / $2,454.71
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,995.26 / $1,995.26 / $2,454.71
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,630.27 / $2,691.53 / $3,019.95
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,630.27 / $2,691.53 / $3,019.95
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,862.09 / $2,570.40 / $3,090.30
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$79.43 / $1,513.56 / $3,019.95
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,398.83 / $2,754.23 / $4,265.80