go back

Pennsylvania 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
$1,499.00 / $5,958.00 / $14,307.48
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7,799.00 / $16,192.96 / $16,192.96
Capital Blue Cross
Facility/Professional
Facility
Modifier
Low / Median / High Price
$27,959.00 / $46,478.00 / $66,617.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,570.00 / $8,956.00 / $12,668.00
Highmark BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10,623.99 / $14,365.01 / $55,649.69
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,301.00 / $6,551.00 / $21,469.04
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$700.00 / $3,649.00 / $16,192.96
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
$3,591.00 / $8,538.00 / $41,482.00