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Tibial/Peroneal Intravascular Lithotripsy

Virginia 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 $8,913 · 10th–90th $3,467$19,0550%20%10th90th$8,913Professionalmedian $6,761 · 10th–90th $1,549$16,2180%20%10th90th$6,761$0.0$0.2$2.0$20.0$200.0$2.0K$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
$3,235.94
Median
$7,079.46
Typical High
$10,715.19
Aetna
Setting
Professional
Modifier
Global
Typical Low
$2,511.89
Median
$5,370.32
Typical High
$9,772.37
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$11,748.98
Median
$14,791.08
Typical High
$15,848.93
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$0.02
Median
$0.02
Typical High
$0.02
Medcost
Setting
Facility
Modifier
Global
Typical Low
$15,848.93
Median
$15,848.93
Typical High
$15,848.93
Sentara
Setting
Facility
Modifier
Global
Typical Low
$10,000.00
Median
$13,489.63
Typical High
$30,199.52
Sentara
Setting
Professional
Modifier
Global
Typical Low
$10,000.00
Median
$13,489.63
Typical High
$30,199.52
United
Setting
Facility
Modifier
Global
Typical Low
$10,715.19
Median
$17,782.79
Typical High
$36,307.81