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Pennsylvania rates for HCPCS C9605

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
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,020.00 / $4,761.00 / $9,534.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$700.00 / $1,544.00 / $7,799.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,570.00 / $8,956.00 / $12,668.00
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,013.00 / $5,350.00 / $10,527.00
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$700.00 / $2,843.00 / $38,269.00
Priority Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,624.00 / $7,463.00 / $23,196.00
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$162.00 / $3,000.00 / $41,482.00