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Tibial/Peroneal Intravascular Lithotripsy

Missouri 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 $4,467 · 10th–90th $1,778$9,7720%10%10th90th$4,467Professionalmedian $4,898 · 10th–90th $2,512$10,9650%20%10th90th$4,898$100.0$500.0$2.0K$10.0K$50.0K

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
$1,778.28
Median
$4,168.69
Typical High
$8,511.38
Aetna
Setting
Professional
Modifier
Global
Typical Low
$2,511.89
Median
$4,897.79
Typical High
$10,964.78
Medica
Setting
Facility
Modifier
Global
Typical Low
$1,412.54
Median
$5,248.07
Typical High
$19,054.61
United
Setting
Facility
Modifier
Global
Typical Low
$3,467.37
Median
$5,623.41
Typical High
$15,135.61