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Texas 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
$1,122.02 / $3,801.89 / $13,489.63
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,096.48 / $22,908.68 / $22,908.68
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,897.79 / $7,943.28 / $16,218.10
Christus
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10,232.93 / $10,232.93 / $10,232.93
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$11,220.18 / $11,220.18 / $11,220.18
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$43,651.58 / $43,651.58 / $43,651.58
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,000.00 / $3,715.35 / $12,302.69
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,000.00 / $8,709.64 / $22,387.21
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$11,220.18 / $22,908.68 / $38,904.51
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$79.43 / $79.43 / $79.43
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,630.27 / $8,317.64 / $17,782.79