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Washington 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
$5,116.62 / $14,287.52 / $50,833.73
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16,192.96 / $16,192.96 / $16,192.96
Asuris Northwest Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$23,592.46 / $31,176.05 / $60,313.38
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$17,132.00 / $17,691.00 / $36,898.00
Kaiser Permanente
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10,258.49 / $31,442.55 / $89,234.73
Pacific Source
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8,671.60 / $26,624.00 / $79,999.20
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$22,594.74 / $31,176.05 / $59,636.26
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,340.00 / $13,441.00 / $25,152.00