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Ohio 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
$861.36 / $5,201.00 / $11,627.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$552.96 / $579.26 / $1,143.53
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,794.00 / $3,576.00 / $14,996.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$471.23 / $624.84 / $1,090.20
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$549.99 / $659.99 / $816.88
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$604.99 / $604.99 / $622.03
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$21,571.00 / $21,571.00 / $21,571.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$499.94 / $769.98 / $1,176.76
Medical Mutual of Ohio
Facility/Professional
Professional
Modifier
Low / Median / High Price
$525.59 / $821.40 / $1,136.96
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$75.93 / $557.73 / $801.77
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,233.00 / $4,383.00 / $6,522.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$552.86 / $733.91 / $1,282.78