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Pennsylvania 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
$1,301.00 / $4,597.00 / $8,247.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7,197.00 / $18,028.12 / $18,028.12
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,020.00 / $4,761.00 / $8,247.00
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$600.00 / $2,337.00 / $18,028.12
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,340.00 / $7,000.00 / $12,076.00