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Tibial/Peroneal Intravascular Lithotripsy

Illinois 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 $4,074 · 10th–90th $1,148$11,4820%5%10th90th$4,074Professionalmedian $3,802 · 10th–90th $1,023$10,9650%20%10th90th$3,802$100.0$500.0$2.0K$10.0K

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
$1,148.15
Median
$3,235.94
Typical High
$9,772.37
Aetna
Setting
Professional
Modifier
Global
Typical Low
$2,089.30
Median
$4,265.80
Typical High
$10,964.78
BCBS
Setting
Facility
Modifier
Global
Typical Low
$11,220.18
Median
$16,595.87
Typical High
$19,952.62
Hally Health
Setting
Professional
Modifier
Global
Typical Low
$120.23
Median
$199.53
Typical High
$346.74
Hally Health
Setting
Facility
Modifier
Global
Typical Low
$100.00
Median
$100.00
Typical High
$100.00
United
Setting
Facility
Modifier
Global
Typical Low
$3,715.35
Median
$10,471.29
Typical High
$26,302.68