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New Hampshire rates for HCPCS C9764

Revascularization Endovascular Open Or Percutaneous Any Vessel(S); With Intravascular Lithotripsy Includes Angioplasty Within The Same Vessel(S) When Performed

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.00 / $2,331.21 / $14,929.00
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8,512.20 / $9,458.00 / $17,400.00
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9,956.57 / $16,940.00 / $31,187.26
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$12,399.00 / $12,399.00 / $12,399.00
Well Sense
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,500.00 / $2,750.00 / $3,500.00