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Georgia 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
$4,194.00 / $5,175.00 / $9,036.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6,389.00 / $9,804.54 / $9,804.54
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,406.20 / $4,415.29 / $8,702.00
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$74,999.25 / $74,999.25 / $74,999.25
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,037.66 / $6,037.66 / $6,037.66
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,369.00 / $4,594.00 / $7,647.00