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Michigan rates for HCPCS 52355

Cystourethroscopy, with ureteroscopy and/or pyeloscopy; with resection of ureteral or renal pelvic tumor

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$589.20 / $3,708.00 / $4,933.00
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,490.25 / $4,074.17 / $5,550.14
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$474.81 / $3,708.00 / $4,933.00
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,524.00 / $5,574.00 / $8,339.00