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 | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $524.81 | $4,365.16 | $5,623.41 | |
Medica
| Facility | $630.96 | $870.96 | $1,479.11 | |
Midlands
| Professional | $1,174.90 | $1,258.93 | $1,258.93 | |
Sanford Health Plan
| Professional | $676.08 | $977.24 | $1,122.02 | |
United
| Facility | $6,606.93 | $6,606.93 | $6,606.93 |