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Pennsylvania 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
$1,412.54 / $6,606.93 / $9,772.37
Capital Blue Cross
Facility/Professional
Facility
Modifier
Low / Median / High Price
$20,417.38 / $21,379.62 / $57,543.99
Highmark BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,238.72 / $40,738.03 / $87,096.36
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,071.52 / $5,370.32 / $9,772.37
Oscar Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,148.15 / $1,148.15 / $1,148.15
UPMC Health Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$562.34 / $575.44 / $1,174.90
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,311.31 / $8,128.31 / $35,481.34