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Wisconsin rates for HCPCS 75956

Endovascular repair of descending thoracic aorta (eg, aneurysm, pseudoaneurysm, dissection, penetrating ulcer, intramural hematoma, or traumatic disruption); involving coverage of left subclavian artery origin, initial endoprosthesis plus descending thoracic aortic extension(s), if required, to level of celiac artery origin, radiological supervision and interpretation

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$641.36 / $641.36 / $641.36
Cigna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$798.39 / $932.98 / $1,504.87
Quartz
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$1,482.02 / $1,482.02 / $1,482.02