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Wisconsin rates for HCPCS 52353

Cysto W/Ureteroscopy W/Lithotripsy

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$390.18 / $5,041.46 / $16,007.88
Aetna
Facility/Professional
Facility
Modifier
50
Low / Median / High Price
$14,559.66 / $14,559.66 / $14,559.66
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,538.00 / $9,720.00 / $15,579.70
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$989.43 / $1,156.23 / $1,864.95
DeanCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$390.18 / $538.59 / $3,259.54
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$390.18 / $4,200.00 / $14,978.00
Prevea360
Facility/Professional
Facility
Modifier
Low / Median / High Price
$390.18 / $538.59 / $3,259.54
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$754.00 / $1,164.29 / $1,588.73
Quartz
Facility/Professional
Facility
Modifier
Low / Median / High Price
$14,302.50 / $14,302.50 / $14,302.50
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7,301.00 / $11,608.00 / $13,980.00