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
| Professional | $604.16 | $604.16 | $604.16 | |
BCBS
| Facility | $10,129.99 | $22,904.30 | $31,633.28 | |
BCBS
| Professional | $235.93 | $244.89 | $378.27 | |
United
| Professional | $276.74 | $276.74 | $276.74 |