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Massachusetts rates for HCPCS C9775

Revascularization Endovascular Open Or Percutaneous Tibial/Peroneal Artery(Ies); With Intravascular Lithotripsy And Transluminal Stent Placement(S) And Atherectomy Includes Angioplastywithin The Same Vessel (S) When Performed

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,924.00 / $2,747.00 / $5,048.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$20,331.00 / $20,331.00 / $20,331.00
AllWays Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,342.00 / $6,238.00 / $17,462.00
Fallon Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$83.43 / $4,618.00 / $9,239.00
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$31,783.82 / $42,424.48 / $53,438.27
Mass General Brigham
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,342.00 / $6,238.00 / $17,462.00
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,485.00 / $6,474.00 / $13,737.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$39,107.91 / $39,107.91 / $39,107.91