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Dextranomer/Hyaluronic Acid Bulking Agent, Urinary Tract

Alaska 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. In Alaska, 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 3 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$2,399 to $2,512
FacilityA hospital or hospital-owned outpatient department$2,399$2,399 to $2,512

How much rates vary

Facilitymedian $2,399 · 10th to 90th $95 to $3,311Professionalmedian $2,399 · 10th to 90th $95 to $2,512
$100$200$500$1K$2K$5K$10Kfacility $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
$9,332.54
Median
$9,332.54
Typical High
$9,332.54
Aetna
Setting
Professional
Modifier
Global
Typical Low
$95.50
Median
$2,398.83
Typical High
$2,511.89
Moda Health
Setting
Facility
Modifier
Global
Typical Low
$95.50
Median
$2,398.83
Typical High
$2,511.89
Moda Health
Setting
Professional
Modifier
Global
Typical Low
$60.26
Median
$60.26
Typical High
$60.26
Providence
Setting
Facility
Modifier
Global
Typical Low
$95.50
Median
$2,398.83
Typical High
$2,511.89
Providence
Setting
Professional
Modifier
Global
Typical Low
$60.26
Median
$60.26
Typical High
$60.26

Where Alaska sits

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.

Alaska· 25th of 51

$2,399

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.