go back

Arizona rates for HCPCS C9765

Revascularization, endovascular, open or percutaneous, lower extremity artery(ies), except tibial/peroneal; with intravascular lithotripsy, and transluminal stent placement(s), includes angioplasty within the same vessel(s), when performed

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,965.00 / $4,521.00 / $8,239.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15,443.64 / $15,443.64 / $15,443.64
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,107.14 / $7,750.40 / $12,676.75
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,453.20 / $1,937.60 / $2,422.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$23,023.22 / $23,023.22 / $23,023.22
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9,937.73 / $9,937.73 / $9,937.73
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,545.00 / $15,443.64 / $23,011.02
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,560.00 / $10,316.00 / $16,841.00