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Nebraska 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
$4,241.22 / $10,431.19 / $20,928.72
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,615.71 / $1,615.71 / $9,524.45
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$18,424.50 / $24,233.27 / $46,874.97
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,557.00 / $2,653.96 / $3,538.63
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,432.12 / $4,034.90 / $5,426.58
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,060.03 / $3,245.07 / $13,909.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,235.10 / $4,087.75 / $13,276.16
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,244.62 / $4,034.90 / $5,426.58
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,240.00 / $4,198.20 / $5,305.99
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,054.00 / $4,317.00 / $13,909.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,235.10 / $4,007.71 / $4,970.95