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Arizona rates for HCPCS C9604

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; single vessel

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,260.00 / $7,960.15 / $14,183.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16,192.96 / $16,192.96 / $16,192.96
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,107.14 / $8,641.70 / $12,676.75
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,743.84 / $2,252.46 / $2,702.95
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8,008.00 / $11,353.00 / $18,040.00
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10,957.13 / $19,728.00 / $94,442.00
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,110.00 / $19,833.00 / $97,300.00