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Arizona rates for HCPCS C9758

Blind procedure for NYHA Class III/IV heart failure; transcatheter implantation of interatrial shunt including right heart catheterization, transesophageal echocardiography (TEE)/intracardiac echocardiography (ICE), and all imaging with or without guidance (e.g., ultrasound, fluoroscopy), performed in an approved investigational device exemption (IDE) study

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,965.00 / $5,013.00 / $9,901.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16,737.61 / $16,737.61 / $16,737.61
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$393.19 / $1,446.21 / $2,365.44
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,384.00 / $6,810.00 / $11,892.00
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,598.00 / $18,411.37 / $35,416.11
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,541.00 / $16,316.00 / $34,918.00