go back

Alaska rates for HCPCS 52317

Litholapaxy: crushing or fragmentation of calculus by any means in bladder and removal of fragments; simple or small (less than 2.5 cm)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,424.52 / $5,173.96 / $13,413.92
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$356.18 / $1,130.17 / $3,834.37
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,211.83 / $1,211.83 / $2,717.84
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$437.43 / $2,284.35 / $5,368.12
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$997.56 / $2,420.71 / $5,580.41
Premera BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,377.00 / $2,241.15 / $4,804.22
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$437.43 / $2,284.35 / $5,368.12
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$754.80 / $1,955.82 / $4,804.22
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,029.06 / $3,261.39 / $4,666.84