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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
$4,897.79 / $8,709.64 / $19,498.45
Aetna
Facility/Professional
Facility
Modifier
50
Low / Median / High Price
$5,248.07 / $8,511.38 / $12,302.69
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$407.38 / $512.86 / $1,148.15
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$363.08 / $630.96 / $831.76
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$512.86 / $562.34 / $891.25
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$457.09 / $549.54 / $831.76
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,786.30 / $8,511.38 / $19,498.45
Martin's Point
Facility/Professional
Facility
Modifier
50
Low / Median / High Price
$5,248.07 / $6,165.95 / $12,302.69
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$416.87 / $537.03 / $1,148.15
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$457.09 / $588.84 / $891.25