go back

Indiana rates for HCPCS 51065

Cystotomy, with calculus basket extraction and/or ultrasonic or electrohydraulic fragmentation of ureteral calculus

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$542.49 / $1,391.00 / $14,063.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$542.49 / $585.65 / $736.74
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,536.00 / $7,833.00 / $14,645.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$598.62 / $750.40 / $1,035.55
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$541.42 / $690.05 / $796.22
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$530.80 / $636.97 / $796.22
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,218.40 / $2,218.40 / $2,218.40
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$547.69 / $754.29 / $1,292.76
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,364.00 / $6,094.00 / $10,413.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$544.63 / $673.62 / $1,115.40