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Indiana rates for HCPCS G2171

Percutaneous arteriovenous fistula creation (AVF), direct, any site, using magnetic-guided arterial and venous catheters and radiofrequency energy, including flow-directing procedures (e.g., vascular coil embolization with radiologic supervision and interpretation, when performed) and fistulogram(s), angiography, venography, and/or ultrasound, with radiologic supervision and interpretation, when performed

Insurance Carrier
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,650.00 / $29,026.00 / $56,650.00
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$89,999.10 / $89,999.10 / $89,999.10
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$52,499.48 / $65,624.34 / $89,999.10