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Package

Arterial revascularization

Package

Arterial revascularization

Arterial revascularization restores blood flow in arteries that have become narrowed or blocked, most commonly in the legs due to peripheral artery disease. Depending on the location and severity of the blockage, the surgeon may use a minimally invasive approach such as angioplasty with a balloon or stent, or a surgical bypass using a blood vessel graft. The procedure is performed under anesthesia, and recovery time varies based on the approach used. Most patients experience improved circulation, reduced pain, and better ability to walk or stay active after treatment.
You'd pay up to
$61,505 / Case Rate

A single, all-inclusive pricing methodology for a procedure in healthcare contracts, instead of separate charges for each service.

The estimated total cost of care without any insurance coverage or discounts.

$61,505

Without insurance

What goes into a price?

Negotiated prices across insurers

Lowest
$16,576
Highest
$52,688
Cash price
up to $61,505

Self pay or cash prices vary by facility when paying out of pocket without insurance benefits. The chart shows you how the lowest and highest amounts facilities charge for this service if you were paying without insurance benefits. If you're uninsured or not submitting a claim to insurance, you also have the right to a Good Faith Estimate under federal law. Contact the provider for a copy of your Good Faith Estimate or to better understand payment options available to you.

Procedures included in this package

This list includes the services and fees bundled into the Arterial revascularization Standard Service Package (SSP CA005). The final price for the procedure will depend on which services your provider ultimately performs, your insurance plan and your medical benefits.

Code Code Type Description
HCPCS C1887 Facility Fee Intravascular-catheter Guided Infusion/Perfusion
HCPCS C1874 Facility Fee Coated Stent with Delivery System Deployment
HCPCS C1725 Facility Fee Catheter-guided Transluminal Non-laser Angioplasty with Infusion/Perfusion
HCPCS C1876 Facility Fee Delivery of Non-coated/non-covered Coronary Stent
HCPCS C1769 Facility Fee Controlled Insertion of Thin Wire for Diagnostic Mapping
HCPCS C1894 Facility Fee Insertion of Non-intracardiac Diagnostic/Therapeutic Device/Sheath
HCPCS C1751 Facility Fee Placement of Catheter for Infusing Fluids Peripherally, Centrally, or Midline
HCPCS J3490 Facility Fee Pharmaceuticals without Categories
HCPCS 93005 Facility Fee Electrocardiogram (ECG) with recording only, no interpretation
HCPCS C1760 Facility Fee Implantable/insertable Vascular Closure Device
HCPCS J7030 Facility Fee Intravenous infusion of 1000cc of normal saline
HCPCS J1644 Facility Fee Intramuscular Injection of Anti-coagulant Heparin 1000 Units
HCPCS J2250 Facility Fee Intramuscular injection of 1mg midazolam hydrochloride
HCPCS Q9967 Facility Fee Non-ionic low osmolar contrast, 300-399mg/ml iodine concentration per ml
HCPCS J3010 Facility Fee Intramuscular injection of fentanyl citrate, 0.1mg
HCPCS 75630 Facility Fee Imaging of Aorta and Lower Extremities Using Catheter and X-rays
HCPCS 37221 Facility Fee Iliac Artery Revascularization by Open/Percutaneous/endovascular with Stent & Angioplasty
HCPCS 37221 Professional Fee Iliac Artery Revascularization by Open/Percutaneous/endovascular with Stent & Angioplasty
HCPCS 75716 Professional Fee Radiological Imaging to Examine Blood Vessels in Both Arms
HCPCS 99152 Professional Fee Moderate Sedation with Monitor, Initial 15min, Age 5+

Disclaimer

Southern Ohio Medical Center is committed to empowering our patients to make informed decisions about their healthcare. This includes helping patients understand the cost of care and the availability of financial assistance.

In compliance with federal law, we provide a list of standard charges that are reviewed on an annual basis. Charges for hospital services are not equivalent to the actual amount paid by insurance companies or patients. The amount paid for services is based on many factors, including health insurance benefit plans, applicable discounts, and services provided based on each patient's unique needs.

You'd pay up to
$61,505 / Case Rate

A single, all-inclusive pricing methodology for a procedure in healthcare contracts, instead of separate charges for each service.

The estimated total cost of care without any insurance coverage or discounts.

Disclaimer

Southern Ohio Medical Center is committed to empowering our patients to make informed decisions about their healthcare. This includes helping patients understand the cost of care and the availability of financial assistance.

In compliance with federal law, we provide a list of standard charges that are reviewed on an annual basis. Charges for hospital services are not equivalent to the actual amount paid by insurance companies or patients. The amount paid for services is based on many factors, including health insurance benefit plans, applicable discounts, and services provided based on each patient's unique needs.

What’s the difference between an individual procedure and a Standard Service Package (SSP)?

Individual Procedure

Individual procedures, like blood tests, each have unique prices and billing codes (like a CPT or HCPCS code). While they can be billed alone, they're usually grouped with other procedures on a claim. This grouping is what determines the total cost of your care.

Standard Service Package (SSP)

A SSP combines all medical services, materials, and fees associated with a healthcare visit or procedure into a single bundle to offer a more comprehensive estimate.

Contact us to verify your estimate

Have your service name, codes, and payment preference ready. If you’re using insurance, you may be asked for insurance details like your Member or Group ID.

Service Arterial revascularization
Service Codes HCPCS C1887, HCPCS C1874, HCPCS C1725, HCPCS C1876, HCPCS C1769
Insurance I'm not using insurance
Location Southern Ohio Medical Center
When you contact us, you can say:
"Hi, I'm calling to verify a price for Arterial revascularization I found through Southern Ohio Medical Center's price estimate tool. Here are the codes I’m looking at: HCPCS C1887, HCPCS C1874, HCPCS C1725, HCPCS C1876, HCPCS C1769. I'm not using insurance, can you confirm the cash pay estimate and help me schedule if needed?"
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