go back

Tibial/Peroneal Intravascular Lithotripsy

Michigan 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 $4,898 · 10th–90th $4,898$14,7910%50%90th$4,898Professionalmedian $10,965 · 10th–90th $10,965$10,9650%50%$10,965$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. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$4,897.79
Median
$4,897.79
Typical High
$6,918.31
Aetna
Setting
Professional
Modifier
Global
Typical Low
$10,964.78
Median
$10,964.78
Typical High
$10,964.78
Health Alliance Plan
Setting
Facility
Modifier
Global
Typical Low
$4,897.79
Median
$4,897.79
Typical High
$6,918.31
Health Alliance Plan
Setting
Professional
Modifier
Global
Typical Low
$10,964.78
Median
$10,964.78
Typical High
$10,964.78
United
Setting
Facility
Modifier
Global
Typical Low
$7,585.78
Median
$12,022.64
Typical High
$23,442.29