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Wisconsin rates for HCPCS C9605

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; each additional branch subtended by the bypass graft (list separately in addition to code for primary procedure)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$14,482.00 / $14,482.00 / $17,823.00
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$14,913.00 / $23,358.00 / $38,530.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$18,000.00 / $18,000.00 / $18,000.00
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,100.00 / $1,778.00 / $29,251.00
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$50.00 / $58.40 / $70.00
Security Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$25,543.84 / $29,951.96 / $37,564.47
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,034.00 / $1,641.00 / $30,620.00