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Montana 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
Professional
Modifier
Low / Median / High Price
$1,862.09 / $2,511.89 / $6,309.57
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,884.03 / $2,884.03 / $2,884.03
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,344.23 / $2,344.23 / $2,884.03
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,162.28 / $3,235.94 / $3,890.45
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,162.28 / $3,235.94 / $3,890.45
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,238.72 / $3,090.30 / $3,801.89
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$79.43 / $1,778.28 / $3,548.13
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,884.03 / $3,388.44 / $5,128.61