Hospitals report these codes with terse, inconsistent chargemaster text. This plain-English title was written by an AI model from that text and has not been reviewed by a person, so it can be wrong. The prices on this page come straight from hospital filings and do not depend on it.
Original text from hospital filings
PERCUTANEOUS TRANSLUMINAL REVASCULARIZATION OF OR THROUGH CORONARY ARTERY BYPASS GRAFT (INTERNAL MAMMARY, FREE ARTERIAL, VENOUS), ANY COMBINATION OF DRUG-ELUTING INTRACORONARY STENT, ATHERECTOMY AND ANGIOPLASTY, INCLUDING DISTAL PROTECTION WHEN PERFORMED;
Low
$6.8k
Average
$20.4k
Median
$15.4k
High
$54.5k
Each hospital's average Wellmark rate, under the methodology and billing class chosen below.
49 hospitals; the 90th percentile is 4.2× the 10th. Each bar is a price range and its height is how many hospitals fall in it. Hover a bar, or a row in the ladder, for details.
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61 hospital rates
iThe hospitals that file a Wellmark rate for this code, one row per hospital and set of terms (billing class, payment method, setting). Rates under different terms are never blended, so the terms are shown under each hospital’s name. Figures are the hospital’s averages across its plans.| # | Plans | |||||||
|---|---|---|---|---|---|---|---|---|
| 1 | Sanford USD Medical Center Sioux Falls, SD other · outpatient | 1 | $17.9k | $17.9k | — | — | 1–10 | $17.9k – $17.9k |
| 2 | Allen Memorial Hospital Corporation Waterloo, IA case rate · outpatient | 1 | $10.7k | $10.7k | — | — | — | $10.7k – $10.7k |
| 3 | Catholic Health Initiatives-Iowa Corp Des Moines, IA facility · fee schedule · both | 2 | $11.8k | $11.8k | — | — | — | $11.8k – $11.8k |
| 4 | Catholic Health Initiatives-Iowa Corp Des Moines, IA facility · other · both | 1 | $11.0k | $11.0k | — | — | — | $11.0k – $11.0k |
| 5 | Central Iowa Hospital Corporation Des Moines, IA case rate · outpatient | 1 | $10.8k | $10.8k | — | — | — | $10.8k – $10.8k |
| 6 | Covenant Medical Center Inc Waterloo, IA facility · fee schedule · both | 2 | $11.8k | $11.8k | — | — | — | $11.8k – $11.8k |
| 7 | Covenant Medical Center Inc Waterloo, IA facility · other · both | 1 | $11.0k | $11.0k | — | — | — | $11.0k – $11.0k |
| 8 | Grinnell Regional Medical Center Grinnell, IA case rate · outpatient | 1 | $10.8k | $10.8k | — | — | — | $10.8k – $10.8k |
| 9 | Gundersen Palmer Lutheran Hospital and Clinic Inc West Union, IA facility · case rate · outpatient | 2 | $20.6k | $20.6k | $963 | 5% | — | $19.7k – $21.6k |
| 10 | Holy Cross Hospital-Ft. Lauderdale Ft. Lauderdale, FL facility · case rate · both | 1 | $54.5k | $54.5k | — | — | — | $54.5k – $54.5k |
| 11 | Mercy Fitzgerald Hospital Darby, PA facility · fee schedule · both | 1 | $9.2k | $9.2k | — | — | — | $9.2k – $9.2k |
| 12 | Mercy Health Hackley Campus Muskogen, MI facility · fee schedule · both | 1 | $43.5k | $43.5k | — | — | — | $43.5k – $43.5k |
| 13 | Mercy Health Saint Marys Rockford, MI facility · fee schedule · both | 1 | $19.6k | $19.6k | — | — | — | $19.6k – $19.6k |
| 14 | Mercy Health Services-Iowa Corp. Mason City, IA facility · fee schedule · both | 2 | $11.8k | $11.8k | — | — | — | $11.8k – $11.8k |
| 15 | Mercy Health Services-Iowa Corp. Mason City, IA facility · other · both | 1 | $12.3k | $12.3k | — | — | — | $12.3k – $12.3k |
| 16 | Mercy Medical Center - Dubuque Dubuque, IA facility · fee schedule · both | 2 | $11.8k | $11.8k | — | — | — | $11.8k – $11.8k |
| 17 | Mercy Medical Center - Dubuque Dubuque, IA facility · other · both | 1 | $11.4k | $11.4k | — | — | — | $11.4k – $11.4k |
| 18 | MercyOne Genesis Aledo Medical Center Aledo, IL facility · case rate · outpatient | 1 | $22.8k | $22.8k | — | — | — | $22.8k – $22.8k |
| 19 | MercyOne Genesis Davenport Medical Center IA 52803; 2140 53rd Avenue Bettendorf, IA facility · fee schedule · outpatient | 1 | $10.9k | $10.9k | — | — | — | $10.9k – $10.9k |
| 20 | MercyOne Genesis Davenport West Medical Center Davenport, IA facility · fee schedule · outpatient | 1 | $10.9k | $10.9k | — | — | — | $10.9k – $10.9k |
| 21 | MercyOne Genesis Silvis Medical Center Silvis, IL facility · case rate · outpatient | 1 | $8.4k | $8.4k | — | — | — | $8.4k – $8.4k |
| 22 | MercyOne Genesis Silvis Medical Center Silvis, IL facility · fee schedule · outpatient | 1 | $11.8k | $11.8k | — | — | — | $11.8k – $11.8k |
| 23 | Meriter Hospital, Inc Madison, WI case rate · outpatient | 1 | $37.2k | $37.2k | — | — | — | $37.2k – $37.2k |
| 24 | Meriter Hospital, Inc Madison, WI per diem · outpatient | 1 | $28.4k | $28.4k | — | — | — | $28.4k – $28.4k |
| 25 | Meriter Hospital, Inc Madison, WI percent of total billed charges · inpatientfrom % of charges | 1 | $22.4k | $22.4k | — | — | — | $22.4k – $22.4k |
← Payers reporting HCPCS C9604 · Snapshot 20261111T120946Z-9134e7f7