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Michigan rates for HCPCS 51820

Cystourethroplasty with unilateral or bilateral ureteroneocystostomy

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,375.98 / $4,933.00 / $6,853.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,010.99 / $1,375.98 / $1,375.98
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,520.21 / $6,443.75 / $8,778.16
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$286.41 / $1,538.93 / $2,105.91
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,003.60 / $1,250.03 / $2,216.13
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,087.08 / $4,933.00 / $6,853.00
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,087.08 / $1,223.06 / $1,790.84
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$98.87 / $950.53 / $1,425.52
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,906.00 / $4,645.00 / $6,327.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,211.46 / $1,459.88 / $1,955.58