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West Virginia 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
$4,122.84 / $7,472.06 / $18,348.33
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
$5,241.28 / $12,887.53 / $48,957.80
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,450.00 / $2,450.00 / $2,450.00