go back

Pennsylvania rates for HCPCS 35881

Revision, lower extremity arterial bypass, without thrombectomy, open; with segmental vein interposition

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,207.45 / $3,964.00 / $8,451.00
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
$1,013.00 / $5,342.00 / $8,990.00
UPMC Health Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$984.69 / $984.69 / $1,144.27
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,304.00 / $4,584.00 / $9,631.00