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Tibial/Peroneal Intravascular Lithotripsy

South Dakota 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 October 2026.

How much does Tibial/Peroneal Intravascular Lithotripsy cost?

$10,233

Typical facility fee. In South Dakota, October 2026.

Insurers have agreed to pay about $10,233 for this service. Most negotiated rates run $4,169 to $10,965.

Few insurers publish rates for this combination, so treat this figure as a rough guide.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 5 insurance carriers under federal price transparency rules.

How much rates vary

Facilitymedian $4,786 · 10th to 90th $3,981 to $18,621Professionalmedian $10,965 · 10th to 90th $10,965 to $10,965
$5K$10K$20Kfacility $4,786professional $10,965

Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
None
Typical Low
$4,365.16
Median
$4,365.16
Typical High
$4,365.16
Aetna
Setting
Professional
Modifier
None
Typical Low
$10,964.78
Median
$10,964.78
Typical High
$10,964.78
Cigna
Setting
Facility
Modifier
None
Typical Low
$10,232.93
Median
$10,232.93
Typical High
$10,715.19
Medica
Setting
Facility
Modifier
None
Typical Low
$3,981.07
Median
$4,786.30
Typical High
$18,620.87
Midlands
Setting
Facility
Modifier
None
Typical Low
$10,232.93
Median
$10,715.19
Typical High
$12,882.50
United
Setting
Facility
Modifier
None
Typical Low
$3,981.07
Median
$3,981.07
Typical High
$4,786.30

Where South Dakota sits

The same service costs 229.1 times more in Wyoming than in Montana. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

South Dakota· 19th of 51

$10,233

WY $18,197MT $79.43

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.