go back

Utah 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
$3,162.28 / $6,025.60 / $9,120.11
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,818.38 / $22,908.68 / $22,908.68
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9,120.11 / $19,498.45 / $44,668.36
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,019.95 / $5,128.61 / $15,848.93