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 | $4,305.00 | $8,031.00 | $46,186.00 | |
Anthem BCBS
| Facility | $27,979.00 | $40,526.00 | $50,658.00 | |
Cigna
| Facility | $13,953.00 | $27,808.00 | $45,414.96 | |
United
| Facility | $1,347.00 | $4,156.00 | $48,678.00 |