go back

Pennsylvania rates for HCPCS 75957

Endovascular repair of descending thoracic aorta (eg, aneurysm, pseudoaneurysm, dissection, penetrating ulcer, intramural hematoma, or traumatic disruption); not 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
$307.33 / $520.71 / $913.61
Martin's Point
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$279.39 / $520.71 / $913.61
UPMC Health Plan
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$277.54 / $277.54 / $337.37