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California rates for HCPCS L8604

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

Facilitymedian $2,512 · 10th–90th $100–$8,1280%20%10th90th$2,512Professionalmedian $2,399 · 10th–90th $155–$2,5120%50%10th90th$2,399$50.0$200.0$1.0K$5.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,511.89 / $2,511.89 / $10,000.00
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,398.83 / $2,398.83 / $2,511.89
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$61.66 / $112.20 / $123.03
Blue Shield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$77.62 / $77.62 / $77.62
Blue Shield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$141.25 / $181.97 / $346.74
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$398.11 / $630.96 / $831.76
Lucent Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$100.00 / $100.00 / $100.00
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$141.25 / $2,398.83 / $3,890.45
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $79.43 / $2,398.83