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Michigan 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
$437.79 / $2,056.00 / $7,503.73
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$345.40 / $605.27 / $1,098.36
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,301.45 / $5,021.09 / $6,840.11
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$87.03 / $486.32 / $629.64
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$351.79 / $594.69 / $1,431.21
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$445.67 / $2,056.00 / $7,503.73
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$372.82 / $842.37 / $1,297.93
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$707.98 / $887.53 / $1,274.37
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,524.00 / $5,819.00 / $8,339.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$924.77 / $1,208.17 / $1,495.64