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Michigan 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
$4,897.79 / $4,897.79 / $6,918.31
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
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,897.79 / $4,897.79 / $6,918.31
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15,488.17 / $15,488.17 / $48,977.88
Priority Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10,000.00 / $10,000.00 / $10,000.00
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,918.31 / $12,589.25 / $37,153.52