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Tibial/Peroneal Intravascular Lithotripsy

Iowa rates for HCPCS C9772

Revascularization, endovascular, open or percutaneous, tibial/peroneal artery(ies), with intravascular lithotripsy, includes angioplasty within the same vessel(s), when performed

Rates data updated July 2026.

Facilitymedian $6,761 · 10th–90th $4,169$20,8930%10%10th90th$6,761Professionalmedian $4,786 · 10th–90th $151$10,2330%50%10th90th$4,786$200.0$500.0$1.0K$2.0K$5.0K$10.0K$20.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Small sample; interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$4,168.69
Median
$5,248.07
Typical High
$10,964.78
Aetna
Setting
Professional
Modifier
Global
Typical Low
$4,786.30
Median
$4,786.30
Typical High
$4,786.30
Hally Health
Setting
Professional
Modifier
Global
Typical Low
$151.36
Median
$10,232.93
Typical High
$10,232.93
Medica
Setting
Facility
Modifier
Global
Typical Low
$10,471.29
Median
$16,595.87
Typical High
$33,884.42
United
Setting
Facility
Modifier
Global
Typical Low
$10,471.29
Median
$16,595.87
Typical High
$30,199.52