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Missouri 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
$2,187.76 / $4,365.16 / $7,413.10
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,235.94 / $8,511.38 / $9,772.37
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,238.72 / $2,238.72 / $2,238.72
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,288.25 / $3,162.28 / $15,135.61
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,819.70 / $2,818.38 / $7,244.36