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Wisconsin 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
$14,482.00 / $14,482.00 / $17,823.00
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
$13,676.00 / $22,696.00 / $44,689.00
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$50.00 / $58.40 / $70.00
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$13,676.00 / $21,823.00 / $27,528.00