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Pennsylvania rates for HCPCS 52354

Cystourethroscopy, with ureteroscopy and/or pyeloscopy; with biopsy and/or fulguration of ureteral or renal pelvic lesion

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$715.25 / $4,370.45 / $8,427.00
Aetna
Facility/Professional
Facility
Modifier
50
Low / Median / High Price
$2,337.00 / $8,899.66 / $8,899.66
Capital Blue Cross
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,800.00 / $7,463.00 / $11,048.00
Highmark BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,669.38 / $12,056.16 / $20,167.32
Highmark BCBS
Facility/Professional
Facility
Modifier
50
Low / Median / High Price
$8,729.26 / $8,729.26 / $42,848.50
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$810.00 / $4,606.00 / $8,451.00
Martin's Point
Facility/Professional
Facility
Modifier
50
Low / Median / High Price
$2,337.00 / $8,899.66 / $8,899.66
UPMC Health Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$401.44 / $401.44 / $467.78
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,334.00 / $2,824.00 / $5,678.00