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North Carolina 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
$1,698.24 / $8,709.64 / $10,715.19
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,698.24 / $22,908.68 / $22,908.68
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$25,118.86 / $27,542.29 / $56,234.13
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,760.83 / $15,135.61 / $22,908.68
Wellcare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$43,651.58 / $43,651.58 / $43,651.58