| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $342.97 | $342.97 | $342.97 | |
Anthem BCBS
| Facility | $168.18 | $21,121.00 | $45,387.00 | |
Anthem BCBS
| Professional | $142.94 | $168.18 | $232.08 |
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
| Professional | $342.97 | $342.97 | $342.97 | |
Anthem BCBS
| Facility | $168.18 | $21,121.00 | $45,387.00 | |
Anthem BCBS
| Professional | $142.94 | $168.18 | $232.08 |