go back

Oregon 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
$1,174.90 / $1,479.11 / $13,803.84
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$575.44 / $707.95 / $1,445.44
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$645.65 / $1,230.27 / $1,778.28
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$851.14 / $1,122.02 / $1,479.11
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$676.08 / $1,000.00 / $1,995.26
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$870.96 / $1,047.13 / $1,513.56
Pacific Source
Facility/Professional
Facility
Modifier
Low / Median / High Price
$870.96 / $1,122.02 / $1,174.90
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$645.65 / $831.76 / $1,380.38
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$79.43 / $1,096.48 / $1,584.89
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8,511.38 / $11,748.98 / $13,803.84
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,047.13 / $1,230.27 / $1,584.89
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,995.26 / $10,232.93 / $15,135.61
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$741.31 / $1,122.02 / $1,621.81