go back

Missouri 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
$1,698.24 / $4,265.80 / $8,511.38
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$537.03 / $660.69 / $1,548.82
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,238.72 / $4,677.35 / $8,912.51
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$575.44 / $691.83 / $1,122.02
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$537.03 / $602.56 / $891.25
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$407.38 / $794.33 / $1,288.25
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$660.69 / $1,905.46 / $26,302.68
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$602.56 / $912.01 / $9,772.37
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,819.70 / $2,754.23 / $4,677.35
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$562.34 / $794.33 / $1,318.26