Percutaneous transluminal revascularization of or through coronary artery bypass graft (internal mammary, free arterial, venous), any combination of intracoronary stent, atherectomy and angioplasty, including distal protection when performed; each additional branch subtended by the bypass graft (List separately in addition to code for primary procedure)
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $380.16 | $380.16 | $403.92 | |
Aetna
| Professional | $396.00 | $396.00 | $426.69 | |
BCBS
| Facility | $8,107.00 | $20,665.00 | $27,168.86 | |
BCBS
| Professional | $143.82 | $168.18 | $232.08 | |
United
| Professional | $276.74 | $276.74 | $276.74 |
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