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New York 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
$4,989.00 / $10,355.00 / $24,288.00
CDPHP
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,283.91 / $3,283.91 / $3,283.91
CDPHP
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,283.91 / $3,283.91 / $3,283.91