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South Carolina 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
$1,584.89 / $10,471.29 / $18,197.01
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$549.54 / $630.96 / $1,230.27
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,344.23 / $5,623.41 / $10,471.29
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$512.86 / $724.44 / $1,047.13
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,089.30 / $2,089.30 / $2,089.30
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$602.56 / $758.58 / $1,348.96
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$588.84 / $831.76 / $1,348.96
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.36 / $32.36 / $33.11
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,754.23 / $11,220.18 / $16,982.44
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$537.03 / $691.83 / $1,202.26