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
HC REVASC LITHTRIPSY-STENT-ATH TIBIAL/PERONEAL
Frisco, TX
See all hospitals reporting HCPCS C9775 →Price type
Baylor Scott & White Medical Center - Centennial’s median price of $19.3k is 1% above the median hospital's median price ($19.1k), higher than 52% of the 1,553 hospitals reporting HCPCS C9775. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 10 payers, 38 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 | Cigna local plus facility · case rate · outpatient | $7.0k | $7.0k | — | — | — | $7.0k – $7.0k |
| 2 | Cigna hmo/ppo facility · case rate · outpatient | $8.3k | $8.3k | — | — | — | $8.3k – $8.3k |
| 3 | Superior Healthplan medicaid facility · fee schedule · outpatient | $8.6k | $8.6k | — | — | — | $8.6k – $8.6k |
| 4 | UnitedHealthcare medicaid/chip facility · fee schedule · outpatient | $9.3k | $9.3k | — | — | — | $9.3k – $9.3k |
| 5 | Blue Cross Blue Shield blue advantage facility · percent of total billed charges · outpatientfrom % of charges | $11.0k | $11.0k | — | — | — | $11.0k – $11.0k |
| 6 | Cigna local plus facility · percent of total billed charges · outpatientfrom % of charges | $15.4k | $15.4k | — | — | — | $15.4k – $15.4k |
| 7 | Blue Cross Blue Shield blue premier/high performance network/my bluehealth facility · percent of total billed charges · outpatientfrom % of charges | $15.7k | $15.7k | — | — | — | $15.7k – $15.7k |
| 8 | Baylor Scott White Health Plan bsw premier - large group/bsw premier direct to employer (rate 1)/bswh employee facility · percent of total billed charges · outpatientfrom % of charges | $15.7k | $15.7k | $266 | 2% | — | $15.4k – $16.0k |
| 9 | UnitedHealthcare charter facility · case rate · outpatient | $16.1k | $16.1k | — | — | — | $16.1k – $16.1k |
| 10 | UnitedHealthcare nexus facility · case rate · outpatient | $16.1k | $16.1k | — | — | — | $16.1k – $16.1k |
| 11 | Aetna commercial facility · percent of total billed charges · outpatientfrom % of charges | $17.2k | $17.2k | — | — | — | $17.2k – $17.2k |
| 12 | Baylor Scott White Health Plan medicare advantage facility · fee schedule · outpatient | $17.5k | $17.5k | — | — | — | $17.5k – $17.5k |
| 13 | UnitedHealthcare commercial broad facility · case rate · outpatient | $17.8k | $17.8k | — | — | — | $17.8k – $17.8k |
| 14 | Cigna hmo/ppo facility · percent of total billed charges · outpatientfrom % of charges | $18.2k | $18.2k | — | — | — | $18.2k – $18.2k |
| 15 | Humana medicare facility · fee schedule · outpatient | $18.4k | $18.4k | — | — | — | $18.4k – $18.4k |
| 16 | Baylor Scott White Health Plan bsw plus - large group/bsw premier direct to employer (rate 2) facility · percent of total billed charges · outpatientfrom % of charges | $18.5k | $18.5k | $313 | 2% | — | $18.2k – $18.8k |
| 17 | Blue Cross Blue Shield medicare advantage facility · fee schedule · outpatient | $19.3k | $19.3k | — | — | — | $19.3k – $19.3k |
| 18 | Molina medicare advantage facility · fee schedule · outpatient | $19.3k | $19.3k | — | — | — | $19.3k – $19.3k |
| 19 | Superior Healthplan medicare facility · fee schedule · outpatient | $19.3k | $19.3k | — | — | — | $19.3k – $19.3k |
| 20 | UnitedHealthcare charter facility · percent of total billed charges · outpatientfrom % of charges | $19.5k | $19.5k | — | — | — | $19.5k – $19.5k |
| 21 | UnitedHealthcare nexus facility · percent of total billed charges · outpatientfrom % of charges | $19.5k | $19.5k | — | — | — | $19.5k – $19.5k |
| 22 | Blue Cross Blue Shield blue advantage facility · case rate · outpatient | $19.9k | $19.9k | — | — | — | $19.9k – $19.9k |
| 23 | UnitedHealthcare medicare advantage facility · fee schedule · outpatient | $20.6k | $20.6k | — | — | — | $20.6k – $20.6k |
| 24 | Blue Cross Blue Shield city of dallas facility · percent of total billed charges · outpatientfrom % of charges | $21.0k | $21.0k | — | — | — | $21.0k – $21.0k |
| 25 | UnitedHealthcare commercial broad facility · percent of total billed charges · outpatientfrom % of charges | $21.6k | $21.6k | — | — | — | $21.6k – $21.6k |
Last updated: Jun 29, 2026
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