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Arizona rates for HCPCS C9761

Cystourethroscopy, with ureteroscopy and/or pyeloscopy, with lithotripsy, and ureteral catheterization for steerable vacuum aspiration of the kidney, collecting system, ureter, bladder, and urethra if applicable (must use a steerable ureteral catheter)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,137.96 / $4,677.35 / $8,317.64
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,238.72 / $9,772.37 / $9,772.37
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$549.54 / $1,778.28 / $2,691.53
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$138.04 / $389.05 / $776.25
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8,709.64 / $8,709.64 / $8,709.64
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,344.23 / $4,168.69 / $12,882.50
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,137.96 / $3,630.78 / $8,128.31