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 |
|---|---|---|---|---|---|
BCBS
| Facility | $4,786.30 | $8,317.64 | $15,848.93 | |
Cigna
| Facility | $16,982.44 | $16,982.44 | $50,118.72 | |
United
| Facility | $2,884.03 | $6,165.95 | $14,125.38 | |
United
| Professional | $234.42 | $275.42 | $275.42 |
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