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Maryland rates for HCPCS 52005

Cystourethroscopy, with ureteral catheterization, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service;

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$40.74 / $1,230.27 / $6,918.31
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$134.90 / $316.23 / $741.31
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$128.82 / $141.25 / $181.97
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,023.29 / $1,023.29 / $1,023.29
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$138.04 / $288.40 / $602.56
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$257.04 / $346.74 / $562.34
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,621.81 / $1,621.81 / $1,621.81
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$123.03 / $263.03 / $512.86
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$234.42 / $380.19 / $467.74