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Washington 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
$5,128.00 / $12,214.00 / $27,982.24
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16,737.61 / $16,737.61 / $16,737.61
Asuris Northwest Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$36,382.71 / $52,051.74 / $100,699.63
Kaiser Permanente
Facility/Professional
Facility
Modifier
Low / Median / High Price
$17,500.50 / $47,539.40 / $114,379.58
Pacific Source
Facility/Professional
Facility
Modifier
Low / Median / High Price
$17,500.50 / $44,451.00 / $79,999.20
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$36,382.71 / $51,644.57 / $99,569.09
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,252.00 / $25,743.00 / $37,152.00