| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
BCBS
| Facility | $18,025.04 | $21,008.82 | $28,463.61 | |
Health Alliance Plan
| Facility | $2,056.00 | $3,933.55 | $4,933.00 |
Revascularization, endovascular, open or percutaneous, tibial/peroneal artery, unilateral, each additional vessel; with transluminal stent placement(s), includes angioplasty within the same vessel, when performed (List separately in addition to code for primary procedure)
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
BCBS
| Facility | $18,025.04 | $21,008.82 | $28,463.61 | |
Health Alliance Plan
| Facility | $2,056.00 | $3,933.55 | $4,933.00 |