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New York rates for HCPCS 61623

Endovascular temporary balloon arterial occlusion, head or neck (extracranial/intracranial) including selective catheterization of vessel to be occluded, positioning and inflation of occlusion balloon, concomitant neurological monitoring, and radiologic supervision and interpretation of all angiography required for balloon occlusion and to exclude vascular injury post occlusion

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$750.55 / $5,390.10 / $11,996.00
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,989.00 / $9,720.00 / $16,411.00
CDPHP
Facility/Professional
Facility
Modifier
Low / Median / High Price
$792.39 / $792.39 / $13,477.50
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$657.20 / $657.20 / $7,227.90
Emblem Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$319.00 / $947.03 / $1,570.46
Highmark BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$11,843.62 / $11,843.62 / $11,843.62
MVP Health Care
Facility/Professional
Facility
Modifier
Low / Median / High Price
$555.00 / $657.20 / $7,227.90
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,705.00 / $7,719.00 / $17,688.00
Univera
Facility/Professional
Facility
Modifier
Low / Median / High Price
$655.00 / $655.00 / $2,685.99