go back

Indiana rates for HCPCS C9767

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,386.00 / $4,846.00 / $16,042.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,173.00 / $1,386.00 / $55,931.00
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,841.00 / $32,251.00 / $57,499.79
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$89,999.10 / $89,999.10 / $89,999.10
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$52,499.48 / $65,624.34 / $89,999.10
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$16,976.78 / $16,976.78 / $16,976.78
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,526.00 / $14,061.00 / $19,962.00