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Rhode Island 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
$3,019.95 / $3,715.35 / $3,981.07
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,715.35 / $7,762.47 / $18,620.87
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$41,686.94 / $41,686.94 / $41,686.94