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Indiana 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
$1,386.00 / $4,846.00 / $7,954.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,386.00 / $4,988.00 / $25,130.00
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,575.00 / $24,214.00 / $47,628.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$16,100.00 / $16,100.00 / $16,100.00
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9,619.00 / $16,546.00 / $34,320.00