go back

Utah 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
$3,019.95 / $3,388.44 / $6,025.60
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,819.70 / $2,290.87 / $3,019.95
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,570.40 / $2,818.38 / $3,162.28
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.36 / $33.11 / $6,456.54
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,398.83 / $4,677.35 / $6,165.95
Select Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,659.59 / $4,365.16 / $6,025.60
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,454.71 / $2,951.21 / $4,365.16
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,290.87 / $5,128.61 / $13,803.84
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,862.09 / $2,511.89 / $3,981.07