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Idaho rates for HCPCS C9761

Cystourethroscopy With Ureteroscopy And/Or Pyelo-Scopy With Lithotripsy And Ureteral Catheterization For Steerable Vacuum Aspiration Of The Kidney Collecting System Ureter Bladder And Urethra Ifapplicable (Must Use A Steerable Ureteral Catheter) (Desc Rvsd 1/1/23)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,500.00 / $9,804.54 / $9,804.54
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9,804.54 / $9,804.54 / $9,804.54
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10,480.23 / $22,875.82 / $28,539.36
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,550.00 / $12,152.00 / $12,233.00