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Ohio 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
$2,085.23 / $7,155.00 / $11,627.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,085.23 / $2,085.23 / $4,114.10
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,084.00 / $4,426.00 / $19,117.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,677.60 / $2,213.11 / $3,639.60
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,815.14 / $2,643.09 / $3,336.66
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,957.51 / $2,086.19 / $3,470.13
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$21,571.00 / $21,571.00 / $21,571.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,672.77 / $2,500.69 / $3,953.83
Medical Mutual of Ohio
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,876.10 / $2,722.49 / $3,953.83
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$184.79 / $1,827.59 / $2,565.46
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,480.00 / $3,086.00 / $6,792.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,923.63 / $2,518.56 / $3,934.39