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Utah 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
$3,038.00 / $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