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Maine rates for HCPCS 52356

Cystourethroscopy, with ureteroscopy and/or pyeloscopy; with lithotripsy including insertion of indwelling ureteral stent (eg, Gibbons or double-J type)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,733.39 / $7,160.00 / $12,311.55
Aetna
Facility/Professional
Facility
Modifier
50
Low / Median / High Price
$5,230.38 / $6,147.23 / $8,810.95
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$421.41 / $531.16 / $631.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$495.69 / $554.28 / $838.92
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$517.47 / $614.63 / $880.57
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$456.21 / $587.55 / $901.35
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,918.76 / $8,773.85 / $16,515.45
Martin's Point
Facility/Professional
Facility
Modifier
50
Low / Median / High Price
$5,230.38 / $6,147.23 / $12,247.38
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$429.44 / $531.16 / $661.67
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$457.21 / $592.73 / $907.02