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Missouri 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
$2,507.00 / $5,560.00 / $12,154.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,507.00 / $4,498.00 / $8,000.00
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
$2,578.00 / $5,634.00 / $23,165.46
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,578.00 / $5,252.00 / $19,082.00