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Arizona 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
$585.00 / $1,650.00 / $5,506.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$351.38 / $794.93 / $1,741.04
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$438.60 / $1,841.09 / $2,741.90
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$282.44 / $338.93 / $735.04
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,049.52 / $3,049.52 / $3,049.52
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$340.24 / $792.78 / $1,609.28
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$355.48 / $874.42 / $3,435.90
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$818.64 / $1,184.83 / $7,358.63
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,343.00 / $3,339.00 / $5,838.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$774.07 / $999.60 / $1,802.32