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Utah 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
$3,038.00 / $5,743.00 / $8,802.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,992.00 / $2,843.00 / $7,679.00
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$12,815.02 / $17,467.05 / $25,454.49
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$871.00 / $4,455.00 / $7,048.00