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Michigan rates for HCPCS 35122

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,519.01 / $4,933.00 / $4,933.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,842.56 / $2,519.01 / $2,612.31
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10,355.98 / $12,070.26 / $16,353.28
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$488.10 / $2,622.76 / $4,141.21
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,671.17 / $2,622.80 / $3,413.95
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,300.04 / $4,933.00 / $4,933.00
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,149.33 / $2,300.04 / $3,196.51
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$164.25 / $1,642.55 / $2,461.68
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,906.00 / $4,645.00 / $6,740.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,181.42 / $2,721.32 / $3,658.68