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Utah 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
$660.69 / $6,025.60 / $8,709.64
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7,244.36 / $8,511.38 / $19,952.62
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$602.56 / $741.31 / $1,023.29
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,995.26 / $5,128.61 / $7,079.46