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Pennsylvania 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
$1,445.44 / $5,495.41 / $9,772.37
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,445.44 / $15,488.17 / $15,488.17
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10,000.00 / $10,000.00 / $10,000.00
Highmark BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9,772.37 / $47,863.01 / $57,543.99
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,047.13 / $4,786.30 / $9,772.37
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$707.95 / $5,011.87 / $15,488.17
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,311.31 / $8,128.31 / $56,234.13
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10,000.00 / $10,000.00 / $10,000.00