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
REVASC LITHOTRIP TIBI/PERONE
Arlington, TX
See all hospitals reporting HCPCS C9772 →Price type
AMH Cath Labs LLC’s median price of $16.7k is 30% above the median hospital's median price ($12.8k), higher than 74% of the 1,709 hospitals reporting HCPCS C9772. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 9 payers, 35 plan rates. A facility fee, a professional fee, a per diem and a case rate are different bills, so each is listed on its own. Open a payer to see it across hospitals.
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| # | |||||||
|---|---|---|---|---|---|---|---|
| 1 | Blue Cross Blue Shield managed medicaid fee schedule · outpatient | $4.8k | $4.8k | — | — | — | $4.8k – $4.8k |
| 2 | UnitedHealthcare managed medicaid fee schedule · outpatient | $4.8k | $4.8k | — | — | — | $4.8k – $4.8k |
| 3 | WellCare managed medicaid fee schedule · outpatient | $5.0k | $5.0k | — | — | — | $5.0k – $5.0k |
| 4 | Molina managed medicaid fee schedule · outpatient | $5.1k | $5.1k | — | — | — | $5.1k – $5.1k |
| 5 | Aetna managed medicaid fee schedule · outpatient | $5.2k | $5.2k | — | — | — | $5.2k – $5.2k |
| 6 | Blue Cross Blue Shield exchange percent of total billed charges · outpatientfrom % of charges | $9.1k | $9.1k | — | — | — | $9.1k – $9.1k |
| 7 | Blue Cross Blue Shield exchange case rate · outpatient | $11.5k | $11.5k | — | — | — | $11.5k – $11.5k |
| 8 | Blue Cross Blue Shield medicare advantage case rate · outpatient | $11.6k | $11.6k | — | — | — | $11.6k – $11.6k |
| 9 | Humana medicare advantage case rate · outpatient | $12.1k | $12.1k | — | — | — | $12.1k – $12.1k |
| 10 | Humana medicare advantage ppo case rate · outpatient | $12.1k | $12.1k | — | — | — | $12.1k – $12.1k |
| 11 | Molina medicare advantage case rate · outpatient | $12.2k | $12.2k | — | — | — | $12.2k – $12.2k |
| 12 | WellCare medicare advantage hmo case rate · outpatient | $12.2k | $12.2k | — | — | — | $12.2k – $12.2k |
| 13 | WellCare medicare advantage mmp case rate · outpatient | $12.8k | $12.8k | — | — | — | $12.8k – $12.8k |
| 14 | UnitedHealthcare medicare advantage ppo case rate · outpatient | $12.9k | $12.9k | — | — | — | $12.9k – $12.9k |
| 15 | Aetna whole health percent of total billed charges · outpatientfrom % of charges | $13.1k | $13.1k | — | — | — | $13.1k – $13.1k |
| 16 | UnitedHealthcare medicare advantage hmo case rate · outpatient | $13.1k | $13.1k | — | — | — | $13.1k – $13.1k |
| 17 | Blue Cross Blue Shield hmo percent of total billed charges · outpatientfrom % of charges | $14.5k | $14.5k | — | — | — | $14.5k – $14.5k |
| 18 | Blue Cross Blue Shield ppo percent of total billed charges · outpatientfrom % of charges | $16.1k | $16.1k | — | — | — | $16.1k – $16.1k |
| 19 | Cigna oap/hmo percent of total billed charges · outpatientfrom % of charges | $17.3k | $17.3k | — | — | — | $17.3k – $17.3k |
| 20 | Aetna commercial percent of total billed charges · outpatientfrom % of charges | $17.4k | $17.4k | — | — | — | $17.4k – $17.4k |
| 21 | UnitedHealthcare all payer case rate · outpatient | $19.5k | $19.5k | — | — | — | $19.5k – $19.5k |
| 22 | Phcs ppo percent of total billed charges · outpatientfrom % of charges | $21.8k | $21.8k | — | — | — | $21.8k – $21.8k |
| 23 | Cigna ppo percent of total billed charges · outpatientfrom % of charges | $21.8k | $21.8k | — | — | — | $21.8k – $21.8k |
| 24 | Aetna asa percent of total billed charges · outpatientfrom % of charges | $22.0k | $22.0k | — | — | — | $22.0k – $22.0k |
| 25 | Aetna coventry percent of total billed charges · outpatientfrom % of charges | $22.0k | $22.0k | — | — | — | $22.0k – $22.0k |
Last updated: Apr 21, 2026
See Lithotripsy-assisted angioplasty of leg artery pricing across every hospital in the network reporting it, or ask Claude or any MCP client directly — see how to connect.