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Imaging For Upper Extension Of Chest Aorta Graft

Oklahoma rates for HCPCS 75958

Covers the live X-ray guidance and the radiologist's interpretation while an extra length of stent graft is added at the upstream end of a repair already sitting in the main artery of the chest, carrying the lined section further back toward the heart so the seal holds.

Rates data updated October 2026.

How much rates vary

Facilitymedian $245 · 10th to 90th $158 to $309Professionalmedian $275 · 10th to 90th $174 to $2,138
$200$500$1K$2Kfacility $245professional $275

Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Medica
Setting
Facility
Modifier
None
Typical Low
$158.49
Median
$245.47
Typical High
$309.03
Medica
Setting
Professional
Modifier
None (both parts)
Typical Low
$173.78
Median
$275.42
Typical High
$2,137.96
Medica
Setting
Professional
Modifier
26 · Professional part
Typical Low
$165.96
Median
$223.87
Typical High
$1,148.15
1 more rate with less common billing modifiers

A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.

Insurance Carrier
Medica
Setting
Professional
Modifier
TC · Technical part
Typical Low
$331.13
Median
$1,819.70
Typical High
$2,089.30