| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $9,285.00 | $10,900.00 | $14,552.94 | |
Aetna
| Professional | $13,413.92 | $13,413.92 | $14,552.94 |
Percutaneous transluminal revascularization of or through coronary artery bypass graft (internal mammary, free arterial, venous), any combination of drug-eluting 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
| Facility | $9,285.00 | $10,900.00 | $14,552.94 | |
Aetna
| Professional | $13,413.92 | $13,413.92 | $14,552.94 |