go back

Idaho 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
$637.37 / $2,426.54 / $7,888.08
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$372.82 / $783.17 / $2,039.11
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$485.71 / $663.81 / $1,545.88
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$433.39 / $975.09 / $2,390.61
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$548.66 / $1,355.11 / $1,642.56
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.34 / $32.34 / $1,319.20
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,399.76 / $8,522.07 / $10,689.08
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$521.73 / $644.74 / $1,654.25
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,550.00 / $12,152.00 / $12,233.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$864.12 / $1,236.76 / $1,847.79