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Tennessee 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
$1,100.00 / $2,683.00 / $7,602.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$559.35 / $657.24 / $773.22
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,917.00 / $3,611.00 / $5,878.00
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$540.71 / $727.17 / $1,253.89
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$589.00 / $798.97 / $1,276.93
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,222.84 / $9,388.90 / $26,542.00
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9,677.00 / $9,677.00 / $9,677.00
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,695.00 / $3,616.00 / $6,285.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$560.50 / $793.69 / $1,329.65