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Pennsylvania rates for HCPCS 35876

Thrombectomy of arterial or venous graft (other than hemodialysis graft or fistula); with revision of arterial or venous graft

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,119.33 / $5,254.00 / $10,398.00
Capital Blue Cross
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8,639.91 / $11,851.00 / $28,970.26
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,301.00 / $5,526.00 / $11,083.00
UPMC Health Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$906.66 / $906.66 / $998.41
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,304.00 / $4,584.00 / $9,631.00