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Dextranomer/Hyaluronic Acid Bulking Agent, Urinary Tract

Nationwide rates for HCPCS L8604

Injectable bulking agent, dextranomer/hyaluronic acid copolymer implant, urinary tract, 1 ml, includes shipping and necessary supplies

Rates data updated July 2026.

How much does Dextranomer/Hyaluronic Acid Bulking Agent, Urinary Tract cost?

$2,399

Typical negotiated rate. Nationwide, July 2026.

Insurers have agreed to pay about $2,399 for this service. The price depends on where it is billed: about $2,399 from a physician practice, and about $2,399 from a hospital or other facility. The two figures are alternatives, not parts of one bill.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 36 insurance carriers under federal price transparency rules.

Where it's billed changes the price

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$2,399$170 to $2,399
FacilityA hospital or hospital-owned outpatient department$2,399$2,399 to $3,631

How much rates vary

Facilitymedian $2,399 · 10th to 90th $129 to $8,318Professionalmedian $2,399 · 10th to 90th $95 to $2,399
$1$10$100$1K$10K$100Kfacility $2,399professional $2,399

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$2,089.30
Median
$2,398.83
Typical High
$8,511.38
Aetna
Setting
Professional
Modifier
Global
Typical Low
$1,548.82
Median
$2,398.83
Typical High
$2,511.89
BCBS
Setting
Facility
Modifier
Global
Typical Low
$123.03
Median
$123.03
Typical High
$239.88
BCBS
Setting
Professional
Modifier
Global
Typical Low
$63.10
Median
$112.20
Typical High
$158.49
Cigna
Setting
Facility
Modifier
Global
Typical Low
$64.57
Median
$64.57
Typical High
$64.57
Cigna
Setting
Professional
Modifier
Global
Typical Low
$162.18
Median
$1,096.48
Typical High
$1,096.48
United
Setting
Facility
Modifier
Global
Typical Low
$60.26
Median
$60.26
Typical High
$1,258.93
United
Setting
Professional
Modifier
Global
Typical Low
$44.67
Median
$44.67
Typical High
$38,018.94

What it costs in each state

The same service costs 26.3 times more in Vermont than in Mississippi. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

Touch or drag across the chart to see any state's rate.

VT $2,512MS $95.50

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.