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Arizona rates for HCPCS C9764

Revascularization, endovascular, open or percutaneous, lower extremity artery(ies), except tibial/peroneal; with intravascular lithotripsy, includes angioplasty within the same vessel(s), when performed

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,137.96 / $4,677.35 / $8,317.64
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,238.72 / $22,908.68 / $22,908.68
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,949.84 / $6,309.57 / $9,332.54
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,949.84 / $2,041.74 / $6,165.95
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$14,125.38 / $14,125.38 / $14,125.38
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,888.44 / $9,332.54 / $33,113.11
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,370.32 / $7,413.10 / $10,964.78