Percutaneous transluminal revascularization of chronic total occlusion, coronary artery, coronary artery branch, or coronary artery bypass graft, any combination of intracoronary stent, atherectomy and angioplasty; each additional coronary artery, coronary artery branch, or bypass graft (List separately in addition to code for primary procedure)
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $725.00 | $725.00 | $770.31 | |
Aetna
| Professional | $694.49 | $755.21 | $802.85 | |
BCBS
| Facility | $8,107.00 | $21,015.00 | $27,168.86 | |
BCBS
| Professional | $161.80 | $170.28 | $233.01 | |
United
| Facility | $4,334.00 | $4,334.00 | $13,976.00 | |
United
| Professional | $276.74 | $276.74 | $276.74 |
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