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Washington rates for HCPCS 53400

Urethroplasty; first stage, for fistula, diverticulum, or stricture (eg, Johannsen type)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,456.35 / $5,128.00 / $18,800.00
Asuris Northwest Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8,562.96 / $14,663.54 / $28,049.69
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,585.08 / $3,585.08 / $5,972.71
Kaiser Permanente
Facility/Professional
Facility
Modifier
Low / Median / High Price
$986.16 / $1,797.67 / $8,210.75
Pacific Source
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,195.10 / $1,548.37 / $1,601.30
Premera BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,060.02 / $1,092.23 / $2,173.03
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9,508.65 / $14,655.16 / $28,049.69
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,155.00 / $3,297.00 / $12,835.00