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Washington 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
$4,500.00 / $13,746.00 / $33,017.40
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$23,029.85 / $23,029.85 / $23,029.85
Asuris Northwest Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$20,135.12 / $31,176.05 / $60,313.38
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$18,364.75 / $18,364.75 / $18,364.75
Kaiser Permanente
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10,258.49 / $18,839.72 / $50,029.96
Pacific Source
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10,481.81 / $26,624.00 / $79,999.20
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$20,135.12 / $30,484.25 / $59,636.26
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,028.00 / $11,540.00 / $20,708.00