go back

Texas 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
$828.00 / $3,620.00 / $12,040.00
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,317.00 / $6,432.06 / $12,610.23
Christus
Facility/Professional
Facility
Modifier
Low / Median / High Price
$404.15 / $404.15 / $404.15
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,619.61 / $3,619.61 / $3,619.61
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$11,500.00 / $26,542.00 / $26,542.00
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$456.17 / $619.63 / $1,061.44
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$456.17 / $632.04 / $1,253.86
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,154.00 / $3,347.00 / $7,600.00