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Texas 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
$1,693.44 / $5,164.67 / $13,180.18
Aetna
Facility/Professional
Facility
Modifier
22
Low / Median / High Price
$1,699.55 / $1,699.55 / $1,699.55
Aetna
Facility/Professional
Facility
Modifier
50
Low / Median / High Price
$3,563.00 / $8,540.34 / $14,009.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$398.17 / $434.01 / $862.57
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$394.53 / $410.20 / $523.17
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,631.91 / $6,389.75 / $12,610.23
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$329.70 / $458.00 / $642.91
Baylor Scott & White
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,940.05 / $5,601.05 / $12,975.53
Baylor Scott & White
Facility/Professional
Professional
Modifier
Low / Median / High Price
$624.77 / $817.02 / $896.06
Christus
Facility/Professional
Facility
Modifier
Low / Median / High Price
$359.96 / $4,790.83 / $4,790.83
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,619.61 / $3,619.61 / $3,619.61
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$427.47 / $553.66 / $865.43
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$55.00 / $55.00 / $14,302.50
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,991.20 / $3,057.36 / $3,404.25
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$398.25 / $507.62 / $1,131.24
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$438.36 / $609.72 / $741.23
Oscar Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,069.24 / $4,199.75 / $14,211.49
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$521.60 / $521.60 / $521.60
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$398.06 / $501.00 / $1,039.16
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$431.17 / $564.83 / $867.78
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,093.00 / $6,000.00 / $13,134.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$345.88 / $475.59 / $735.00
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$340.12 / $390.48 / $537.64