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 Revascularization Endovascular Open/Perc Lower Extremity Art Excpt T/P W/Intravasc Lithotripsy Lt
Troy, NY
See all hospitals reporting HCPCS C9764 →Price type
Samaritan Hospital’s median price of $12.8k is 6% above the median hospital's median price ($12.1k), higher than 59% of the 1,791 hospitals reporting HCPCS C9764. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 16 payers, 39 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 | UnitedHealthcare united healthcare medicaid harp chip facility · fee schedule · both | $7.3k | $7.3k | — | — | — | $7.3k – $7.3k |
| 2 | Blue Cross Blue Shield blue shield of ne new york hmo facility · percent of total billed charges · bothfrom % of charges | $9.1k | $9.1k | — | — | — | $9.1k – $9.1k |
| 3 | Blue Cross Blue Shield blue shield of ne new york ppo facility · percent of total billed charges · bothfrom % of charges | $9.1k | $9.1k | — | — | — | $9.1k – $9.1k |
| 4 | Carefirst blue shield of ne new york hmo facility · percent of total billed charges · bothfrom % of charges | $9.1k | $9.1k | — | — | — | $9.1k – $9.1k |
| 5 | Carefirst blue shield of ne new york ppo facility · percent of total billed charges · bothfrom % of charges | $9.1k | $9.1k | — | — | — | $9.1k – $9.1k |
| 6 | Excellus blue shield of ne new york ppo facility · percent of total billed charges · bothfrom % of charges | $9.1k | $9.1k | — | — | — | $9.1k – $9.1k |
| 7 | Highmark blue shield of ne new york ascend facility · percent of total billed charges · bothfrom % of charges | $9.1k | $9.1k | — | — | — | $9.1k – $9.1k |
| 8 | Highmark blue shield of ne new york hmo facility · percent of total billed charges · bothfrom % of charges | $9.1k | $9.1k | — | — | — | $9.1k – $9.1k |
| 9 | Highmark blue shield of ne new york ppo facility · percent of total billed charges · bothfrom % of charges | $9.1k | $9.1k | — | — | — | $9.1k – $9.1k |
| 10 | Premera blue shield of ne new york ppo facility · percent of total billed charges · bothfrom % of charges | $9.1k | $9.1k | — | — | — | $9.1k – $9.1k |
| 11 | Regence blue shield of ne new york ppo facility · percent of total billed charges · bothfrom % of charges | $9.1k | $9.1k | — | — | — | $9.1k – $9.1k |
| 12 | Wellmark blue shield of ne new york hmo facility · percent of total billed charges · bothfrom % of charges | $9.1k | $9.1k | — | — | — | $9.1k – $9.1k |
| 13 | Wellmark blue shield of ne new york ppo facility · percent of total billed charges · bothfrom % of charges | $9.1k | $9.1k | — | — | — | $9.1k – $9.1k |
| 14 | Aetna aetna facility · other · both | $10.5k | $10.5k | — | — | — | $10.5k – $10.5k |
| 15 | Medical Mutual aetna facility · other · both | $10.5k | $10.5k | — | — | — | $10.5k – $10.5k |
| 16 | First Health first health facility · percent of total billed charges · bothfrom % of charges | $13.2k | $13.2k | — | — | — | $13.2k – $13.2k |
| 17 | Cigna cigna facility · percent of total billed charges · bothfrom % of charges | $14.0k | $14.0k | — | — | — | $14.0k – $14.0k |
| 18 | Anthem empire bcbs medicare advantage facility · other · both | $14.1k | $14.1k | — | — | — | $14.1k – $14.1k |
| 19 | UnitedHealthcare united healthcare medicare advantage facility · other · both | $14.7k | $14.7k | — | — | — | $14.7k – $14.7k |
| 20 | MultiPlan beech street facility · percent of total billed charges · bothfrom % of charges | $14.8k | $14.8k | — | — | — | $14.8k – $14.8k |
| 21 | MultiPlan multiplan facility · percent of total billed charges · bothfrom % of charges | $14.8k | $14.8k | — | — | — | $14.8k – $14.8k |
| 22 | Phcs multiplan facility · percent of total billed charges · bothfrom % of charges | $14.8k | $14.8k | — | — | — | $14.8k – $14.8k |
| 23 | Aetna aetna medicare advantage facility · other · both | $15.3k | $15.3k | — | — | — | $15.3k – $15.3k |
| 24 | WellCare wellcare medicare advantage facility · other · both | $15.8k | $15.8k | — | — | — | $15.8k – $15.8k |
| 25 | Excellus blue shield of ne new york medicare adv facility · other · both | $15.9k | $15.9k | — | — | — | $15.9k – $15.9k |
Last updated: Mar 31, 2026
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