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Wisconsin 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
$14,482.00 / $14,482.00 / $17,823.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16,737.61 / $16,737.61 / $16,737.61
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$12,080.00 / $17,505.00 / $23,937.00
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$11,078.00 / $20,293.00 / $39,888.00
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$50.00 / $70.00 / $85.00
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$11,078.00 / $19,708.00 / $24,111.00