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Oklahoma rates for HCPCS 52317

Litholapaxy Smpl/Sm <2.5 Cm

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$918.00 / $3,742.00 / $7,500.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$387.66 / $992.64 / $1,091.25
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,464.88 / $8,620.91 / $13,717.10
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$397.13 / $750.19 / $1,209.45
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$403.89 / $552.07 / $1,231.97
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$407.04 / $1,060.08 / $4,240.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$784.01 / $1,440.60 / $7,358.63
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$884.00 / $2,900.00 / $5,543.93
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$747.96 / $1,036.33 / $1,584.24