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New Hampshire 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
$100.00 / $2,331.21 / $14,929.00
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10,334.70 / $11,483.00 / $21,862.00
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32,676.53 / $52,108.87 / $69,931.41
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$12,629.00 / $12,629.00 / $12,629.00
Well Sense
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8,988.26 / $9,887.09 / $10,000.00