| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $373.75 | $1,268.00 | $2,250.00 | |
BCBS
| Facility | $14,961.99 | $18,157.08 | $24,427.08 | |
United
| Facility | $657.00 | $1,835.00 | $6,546.00 |
Endovascular intracranial prolonged administration of pharmacologic agent(s) other than for thrombolysis, arterial, including catheter placement, diagnostic angiography, and imaging guidance; each additional vascular territory (List separately in addition to code for primary procedure)
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $373.75 | $1,268.00 | $2,250.00 | |
BCBS
| Facility | $14,961.99 | $18,157.08 | $24,427.08 | |
United
| Facility | $657.00 | $1,835.00 | $6,546.00 |