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South Carolina 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
$9,062.00 / $20,870.91 / $53,263.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9,062.00 / $9,062.00 / $18,429.00
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$16,036.13 / $28,218.43 / $47,447.41
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$21,239.00 / $32,000.00 / $58,466.00
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$21,050.85 / $21,050.85 / $21,050.85
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.00 / $30.00 / $30.00
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,340.00 / $22,297.00 / $41,346.00