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Pennsylvania 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
$1,301.00 / $4,676.00 / $8,427.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9,804.54 / $9,804.54 / $9,804.54
Highmark BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,224.49 / $19,532.37 / $29,986.12
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,020.00 / $4,831.00 / $8,427.00
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$600.00 / $2,337.00 / $9,804.54
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,175.00 / $2,715.00 / $4,789.00