go back

Tibial/Peroneal Intravascular Lithotripsy

Idaho 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 $12,023 · 10th–90th $4,467$36,3080%10%10th90th$12,023Professionalmedian $10,965 · 10th–90th $4,467$10,9650%50%10th$10,965$50.0$200.0$1.0K$5.0K$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. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$3,388.44
Median
$8,709.64
Typical High
$10,964.78
Aetna
Setting
Professional
Modifier
Global
Typical Low
$4,466.84
Median
$10,964.78
Typical High
$10,964.78
BCBS
Setting
Facility
Modifier
Global
Typical Low
$12,589.25
Median
$22,387.21
Typical High
$36,307.81
BCBS
Setting
Professional
Modifier
Global
Typical Low
$18,620.87
Median
$18,620.87
Typical High
$18,620.87
Moda Health
Setting
Facility
Modifier
Global
Typical Low
$11,481.54
Median
$12,882.50
Typical High
$19,952.62
Molina
Setting
Professional
Modifier
Global
Typical Low
$30.20
Median
$30.20
Typical High
$77.62
Regence BlueShield
Setting
Facility
Modifier
Global
Typical Low
$20,892.96
Median
$26,302.68
Typical High
$37,153.52
Select Health
Setting
Facility
Modifier
Global
Typical Low
$18,620.87
Median
$21,877.62
Typical High
$29,512.09
United
Setting
Facility
Modifier
Global
Typical Low
$12,022.64
Median
$25,118.86
Typical High
$66,069.34