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Tibial/Peroneal Intravascular Lithotripsy

Utah 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 $6,026 · 10th–90th $3,162$16,2180%10%10th90th$6,026Professionalmedian $4,571 · 10th–90th $4,571$7,9430%20%40%90th$4,571$2.0K$5.0K$10.0K$20.0K$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. Small sample; interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$3,162.28
Median
$6,025.60
Typical High
$9,120.11
Aetna
Setting
Professional
Modifier
Global
Typical Low
$4,570.88
Median
$4,570.88
Typical High
$7,943.28
Regence BlueShield
Setting
Facility
Modifier
Global
Typical Low
$16,218.10
Median
$22,387.21
Typical High
$33,884.42
Select Health
Setting
Facility
Modifier
Global
Typical Low
$5,011.87
Median
$5,011.87
Typical High
$5,011.87
United
Setting
Facility
Modifier
Global
Typical Low
$1,698.24
Median
$5,128.61
Typical High
$24,547.09