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Iowa 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
$4,168.69 / $4,786.30 / $7,079.46
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,786.30 / $22,908.68 / $22,908.68
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$151.36 / $21,877.62 / $21,877.62
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8,709.64 / $14,791.08 / $33,884.42
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8,511.38 / $13,489.63 / $30,199.52