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Idaho 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
$4,805.00 / $16,193.00 / $16,193.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16,193.00 / $16,193.00 / $16,193.00
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$19,831.58 / $27,841.54 / $35,402.06
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$12,000.00 / $62,445.00 / $76,459.00