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South 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
$7,943.28 / $11,220.18 / $18,197.01
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$22,908.68 / $22,908.68 / $22,908.68
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,454.71 / $6,760.83 / $13,803.84
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9,772.37 / $9,772.37 / $9,772.37
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$22,908.68 / $34,673.69 / $38,904.51
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.20 / $30.20 / $30.20
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8,709.64 / $20,417.38 / $25,703.96