| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $331.13 | $3,388.44 | $11,220.18 | |
U of Utah Health Plan
| Professional | $354.81 | $436.52 | $602.56 | |
United
| Facility | $2,290.87 | $5,128.61 | $11,481.54 |
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 | $331.13 | $3,388.44 | $11,220.18 | |
U of Utah Health Plan
| Professional | $354.81 | $436.52 | $602.56 | |
United
| Facility | $2,290.87 | $5,128.61 | $11,481.54 |