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Lower Extremity Intravascular Lithotripsy

Wisconsin 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

Rates data updated July 2026.

How much does Lower Extremity Intravascular Lithotripsy cost?

$13,804

Typical facility fee. In Wisconsin, July 2026.

Insurers have agreed to pay about $13,804 for this service. Most negotiated rates run $10,965 to $17,378.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 6 insurance carriers under federal price transparency rules.

How much rates vary

Facilitymedian $13,804 · 10th to 90th $9,772 to $21,878Professionalmedian $20,417 · 10th to 90th $85 to $20,417
$100$500$2K$10Kfacility $13,804professional $20,417

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$8,317.64
Median
$11,220.18
Typical High
$17,782.79
Aetna
Setting
Professional
Modifier
Global
Typical Low
$20,417.38
Median
$20,417.38
Typical High
$20,417.38
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$10,000.00
Median
$13,803.84
Typical High
$22,387.21
Medica
Setting
Facility
Modifier
Global
Typical Low
$7,943.28
Median
$12,882.50
Typical High
$17,782.79
Molina
Setting
Professional
Modifier
Global
Typical Low
$50.12
Median
$58.88
Typical High
$85.11
Network Health
Setting
Facility
Modifier
Global
Typical Low
$9,772.37
Median
$10,715.19
Typical High
$17,378.01
United
Setting
Facility
Modifier
Global
Typical Low
$8,912.51
Median
$13,803.84
Typical High
$17,782.79

Where Wisconsin sits

The same service costs 32.4 times more in Vermont than in Arkansas. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

Wisconsin· 17th of 51

$13,804

VT $58,884AR $1,820

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.