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 | $1,096.48 | $1,445.44 | $2,398.83 | |
BCBS
| Facility | $11,748.98 | $14,125.38 | $19,054.61 | |
Cigna
| Facility | $5,248.07 | $12,022.64 | $22,908.68 | |
United
| Facility | $251.19 | $758.58 | $17,378.01 |