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Wisconsin 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
$6,060.60 / $8,243.00 / $17,823.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7,793.40 / $7,793.40 / $9,804.54
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,538.00 / $9,720.00 / $15,579.70
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,080.00 / $7,318.00 / $10,000.00
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$50.00 / $70.00 / $85.00
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,080.00 / $7,611.00 / $9,134.00