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South Dakota rates for HCPCS C9775

Revascularization, endovascular, open or percutaneous, tibial/peroneal artery(ies); with intravascular lithotripsy and transluminal stent placement(s), and atherectomy, includes angioplasty within the same vessel(s), when performed

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,338.00 / $4,338.00 / $4,338.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$18,028.12 / $18,028.12 / $18,028.12
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,571.00 / $30,467.52 / $49,397.05
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$19,670.59 / $19,670.59 / $22,949.03
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,571.00 / $6,571.00 / $6,571.00