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Maine 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
Professional
Modifier
Low / Median / High Price
$15,488.17 / $15,488.17 / $15,488.17
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10,000.00 / $10,000.00 / $10,000.00
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$107,151.93 / $107,151.93 / $107,151.93
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15,488.17 / $15,488.17 / $15,488.17
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7,413.10 / $7,413.10 / $43,651.58