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New Hampshire 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
$2,398.83 / $3,388.44 / $14,791.08
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9,772.37 / $9,772.37 / $9,772.37
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,011.87 / $5,623.41 / $8,912.51
Harvard Pilgrim
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9,549.93 / $9,549.93 / $9,549.93
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10,471.29 / $14,791.08 / $17,782.79
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9,549.93 / $9,549.93 / $9,549.93
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12,302.69 / $14,454.40 / $17,782.79