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Pennsylvania 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
$832.00 / $4,534.00 / $8,240.00
Capital Blue Cross
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,800.00 / $7,463.00 / $11,048.00
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$926.00 / $4,761.00 / $8,247.00
UPMC Health Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$449.77 / $449.77 / $549.54
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,334.00 / $2,824.00 / $5,678.00