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Michigan 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
$2,454.71 / $4,897.79 / $9,549.93
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7,762.47 / $9,772.37 / $9,772.37
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10,232.93 / $11,481.54 / $15,848.93
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,454.71 / $4,897.79 / $10,715.19
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7,762.47 / $9,772.37 / $13,803.84
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,511.89 / $7,244.36 / $19,054.61