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Tennessee 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
$1,059.99 / $3,062.00 / $7,602.00
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,523.00 / $4,657.00 / $7,950.00
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,552.16 / $14,302.50 / $26,542.00
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,695.00 / $3,626.00 / $6,285.00