| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Medica
| Facility | $372.40 | $3,279.09 | $9,889.06 | |
Midlands
| Facility | $658.93 | $7,387.85 | $10,180.70 | |
Sanford Health Plan
| Professional | $451.47 | $4,895.83 | $6,566.68 |
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 |
|---|---|---|---|---|---|
Medica
| Facility | $372.40 | $3,279.09 | $9,889.06 | |
Midlands
| Facility | $658.93 | $7,387.85 | $10,180.70 | |
Sanford Health Plan
| Professional | $451.47 | $4,895.83 | $6,566.68 |