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Michigan rates for HCPCS C9760

Nonrandomized, nonblinded procedure for NYHA Class II, III, IV heart failure; transcatheter implantation of interatrial shunt, including right and left heart catheterization, transeptal puncture, 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
$4,797.00 / $4,797.00 / $4,933.00
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$31,194.56 / $42,321.44 / $97,522.11
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,797.00 / $4,797.00 / $4,933.00
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,797.00 / $4,797.00 / $4,933.00
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10,555.00 / $18,687.00 / $25,752.00