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Maine 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
Professional
Modifier
Low / Median / High Price
$16,737.61 / $16,737.61 / $16,737.61
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$91,862.50 / $91,862.50 / $91,862.50