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 LITH-STEN-ATH TIB/PER
Teaneck, NJ
See all hospitals reporting HCPCS C9775 →Price type
Holy Name’s median price of $21.1k is 11% above the median hospital's median price ($19.1k), higher than 64% of the 1,544 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: 9 payers, 21 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 | Aetna qualified health plans facility · case rate · outpatient | $4.9k | $4.9k | — | — | — | $4.9k – $4.9k |
| 2 | Aetna hmo/pos facility · case rate · outpatient | $9.9k | $9.9k | — | — | — | $9.9k – $9.9k |
| 3 | UnitedHealthcare medicaid facility · percent of total billed charges · outpatientfrom % of charges | $12.6k | $12.6k | — | — | — | $12.6k – $12.6k |
| 4 | Aetna better health mcd/chip facility · percent of total billed charges · outpatientfrom % of charges | $13.2k | $13.2k | — | — | — | $13.2k – $13.2k |
| 5 | UnitedHealthcare uhc facility · case rate · outpatient | $13.8k | $13.8k | — | — | — | $13.8k – $13.8k |
| 6 | Aetna medicare prime facility · fee schedule · outpatient | $19.0k | $19.0k | — | — | — | $19.0k – $19.0k |
| 7 | Ambetter ambetter facility · percent of total billed charges · outpatientfrom % of charges | $19.7k | $19.7k | — | — | — | $19.7k – $19.7k |
| 8 | Aetna golden medicare facility · fee schedule · outpatient | $21.1k | $21.1k | — | — | — | $21.1k – $21.1k |
| 9 | Clover clover facility · fee schedule · outpatient | $21.1k | $21.1k | — | — | — | $21.1k – $21.1k |
| 10 | UnitedHealthcare medicare facility · fee schedule · outpatient | $21.1k | $21.1k | — | — | — | $21.1k – $21.1k |
| 11 | WellCare medicare facility · fee schedule · outpatient | $21.4k | $21.4k | — | — | — | $21.4k – $21.4k |
| 12 | Aetna whole health facility · percent of total billed charges · outpatientfrom % of charges | $25.4k | $25.4k | — | — | — | $25.4k – $25.4k |
| 13 | First Health first health facility · percent of total billed charges · outpatientfrom % of charges | $37.2k | $37.2k | $32.2k | 87% | — | $5k – $69.5k |
| 14 | Aetna worker's comp facility · percent of total billed charges · outpatientfrom % of charges | $39.8k | $39.8k | $34.2k | 86% | — | $5.6k – $74.0k |
| 15 | MultiPlan multiplan facility · percent of total billed charges · outpatientfrom % of charges | $51.2k | $51.2k | — | — | — | $51.2k – $51.2k |
| 16 | Cigna hmo/pos facility · fee schedule · outpatient | $58.1k | $58.1k | — | — | — | $58.1k – $58.1k |
| 17 | MultiPlan worker's comp facility · percent of total billed charges · outpatientfrom % of charges | $66.9k | $66.9k | — | — | — | $66.9k – $66.9k |
| 18 | MultiPlan auto accident medical facility · percent of total billed charges · outpatientfrom % of charges | $70.9k | $70.9k | — | — | — | $70.9k – $70.9k |
| 19 | Blue Cross Blue Shield indemnity facility · percent of total billed charges · outpatientfrom % of charges | $73.0k | $73.0k | — | — | — | $73.0k – $73.0k |
| 20 | Blue Cross Blue Shield managed facility · percent of total billed charges · outpatientfrom % of charges | $73.0k | $73.0k | — | — | — | $73.0k – $73.0k |
| 21 | Blue Cross Blue Shield ppo facility · percent of total billed charges · outpatientfrom % of charges | $73.0k | $73.0k | — | — | — | $73.0k – $73.0k |
Last updated: Nov 10, 2025
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