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Wisconsin 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
$8,243.00 / $11,239.56 / $17,823.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$23,029.85 / $23,029.85 / $23,029.85
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8,712.00 / $12,656.00 / $19,835.00
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8,627.00 / $13,982.00 / $23,029.85
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$50.00 / $70.00 / $85.00
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8,627.00 / $12,373.00 / $15,090.00