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 INTRA LITHOTRIP-STENT
Valhalla, NY
See all hospitals reporting HCPCS C9765 →Price type
Westchester Medical Center’s median price of $22.8k is 21% above the median hospital's median price ($18.9k), higher than 74% of the 1,757 hospitals reporting HCPCS C9765. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 11 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 blue cross connection/exchange facility · case rate · outpatient | $8.6k | $8.6k | — | — | — | $8.6k – $8.6k |
| 2 | Blue Cross Blue Shield blue cross connection/exchange facility · fee schedule · outpatient | $8.6k | $8.6k | — | — | — | $8.6k – $8.6k |
| 3 | Blue Cross Blue Shield blue cross access facility · case rate · outpatient | $9.2k | $9.2k | — | — | — | $9.2k – $9.2k |
| 4 | Blue Cross Blue Shield blue cross access facility · fee schedule · outpatient | $9.2k | $9.2k | — | — | — | $9.2k – $9.2k |
| 5 | Blue Cross Blue Shield blue cross small group facility · case rate · outpatient | $10.4k | $10.4k | — | — | — | $10.4k – $10.4k |
| 6 | Blue Cross Blue Shield blue cross small group facility · fee schedule · outpatient | $10.4k | $10.4k | — | — | — | $10.4k – $10.4k |
| 7 | UnitedHealthcare uhc compass facility · case rate · outpatient | $10.6k | $10.6k | — | — | — | $10.6k – $10.6k |
| 8 | UnitedHealthcare uhc compass facility · fee schedule · outpatient | $10.6k | $10.6k | — | — | — | $10.6k – $10.6k |
| 9 | UnitedHealthcare uhc exchange facility · case rate · outpatient | $10.6k | $10.6k | — | — | — | $10.6k – $10.6k |
| 10 | UnitedHealthcare uhc exchange facility · fee schedule · outpatient | $10.6k | $10.6k | — | — | — | $10.6k – $10.6k |
| 11 | Aetna aetna hp network facility · case rate · outpatient | $10.7k | $10.7k | — | — | — | $10.7k – $10.7k |
| 12 | Aetna aetna hp network facility · fee schedule · outpatient | $10.7k | $10.7k | — | — | — | $10.7k – $10.7k |
| 13 | Blue Cross Blue Shield blue cross commercial/healthy ny facility · case rate · outpatient | $11.5k | $11.5k | — | — | — | $11.5k – $11.5k |
| 14 | Blue Cross Blue Shield blue cross commercial/healthy ny facility · fee schedule · outpatient | $11.5k | $11.5k | — | — | — | $11.5k – $11.5k |
| 15 | Aetna aetna facility · case rate · outpatient | $11.9k | $11.9k | — | — | — | $11.9k – $11.9k |
| 16 | Aetna aetna facility · fee schedule · outpatient | $11.9k | $11.9k | — | — | — | $11.9k – $11.9k |
| 17 | Aetna aetna employee facility · case rate · outpatient | $11.9k | $11.9k | — | — | — | $11.9k – $11.9k |
| 18 | Aetna aetna employee facility · fee schedule · outpatient | $11.9k | $11.9k | — | — | — | $11.9k – $11.9k |
| 19 | UnitedHealthcare uhc commercial facility · case rate · outpatient | $12.4k | $12.4k | — | — | — | $12.4k – $12.4k |
| 20 | UnitedHealthcare uhc commercial facility · fee schedule · outpatient | $12.4k | $12.4k | — | — | — | $12.4k – $12.4k |
| 21 | UnitedHealthcare uhc empire facility · case rate · outpatient | $12.4k | $12.4k | — | — | — | $12.4k – $12.4k |
| 22 | UnitedHealthcare uhc empire facility · fee schedule · outpatient | $12.4k | $12.4k | — | — | — | $12.4k – $12.4k |
| 23 | Cigna cigna ppo facility · fee schedule · outpatient | $15.5k | $15.5k | — | — | — | $15.5k – $15.5k |
| 24 | Blue Cross Blue Shield blue cross medicare facility · fee schedule · outpatient | $22.8k | $22.8k | — | — | — | $22.8k – $22.8k |
| 25 | Medicare medicare facility · fee schedule · outpatient | $22.8k | $22.8k | — | — | — | $22.8k – $22.8k |
Last updated: Jul 28, 2026
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