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Minnesota 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
$322.97 / $885.67 / $10,267.48
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$322.97 / $885.67 / $1,298.79
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,511.39 / $7,107.25 / $12,389.06
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$619.87 / $1,339.56 / $3,007.49
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,217.67 / $3,144.95 / $7,565.60
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$800.10 / $1,647.72 / $3,635.69
Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,802.82 / $2,875.24 / $5,957.16
Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$711.50 / $1,431.29 / $3,158.75
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$513.07 / $1,511.73 / $4,746.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,152.52 / $2,467.05 / $3,801.60
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,735.00 / $4,974.00 / $8,812.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,057.19 / $2,321.61 / $3,478.48