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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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,500.00 / $10,895.20 / $10,895.20
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10,895.20 / $10,895.20 / $10,895.20
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.00 / $30.00 / $78.00
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$19,831.58 / $27,841.54 / $35,402.06
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$12,000.00 / $24,599.00 / $65,746.00