| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Horizon BCBS
| Professional | $194.98 | $194.98 | $229.09 | |
United
| Facility | $5,888.44 | $10,000.00 | $17,378.01 |
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 |
|---|---|---|---|---|---|
Horizon BCBS
| Professional | $194.98 | $194.98 | $229.09 | |
United
| Facility | $5,888.44 | $10,000.00 | $17,378.01 |