| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $562.34 | $3,388.44 | $6,025.60 | |
U of Utah Health Plan
| Professional | $446.68 | $549.54 | $812.83 | |
United
| Facility | $2,290.87 | $5,128.61 | $13,803.84 |
Bypass graft; autogenous composite, 2 segments of veins from 2 locations (List separately in addition to code for primary procedure)
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $562.34 | $3,388.44 | $6,025.60 | |
U of Utah Health Plan
| Professional | $446.68 | $549.54 | $812.83 | |
United
| Facility | $2,290.87 | $5,128.61 | $13,803.84 |