go back

Illinois 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
$1,202.26 / $4,786.30 / $9,772.37
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,089.30 / $22,908.68 / $22,908.68
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$11,748.98 / $16,595.87 / $19,952.62
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$120.23 / $199.53 / $346.74
Hally Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.00 / $100.00 / $100.00
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,570.40 / $7,943.28 / $16,982.44