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Wisconsin 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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8,317.64 / $8,317.64 / $17,782.79
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10,964.78 / $10,964.78 / $10,964.78
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$12,882.50 / $18,197.01 / $29,512.09
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8,511.38 / $15,135.61 / $23,988.33
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$50.12 / $58.88 / $85.11
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8,709.64 / $16,982.44 / $22,387.21