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Ohio 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
$3,696.00 / $7,799.00 / $13,726.36
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9,804.54 / $9,804.54 / $9,804.54
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,084.00 / $4,426.00 / $19,117.00
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$65,624.34 / $65,624.34 / $65,624.34
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$104,998.95 / $104,998.95 / $104,998.95
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$21,571.00 / $21,571.00 / $21,571.00
Medical Mutual of Ohio
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9,313.87 / $9,313.87 / $15,016.01
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,647.00 / $4,410.00 / $7,351.00