go back

Minnesota rates for HCPCS L8604

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,374.87 / $2,374.87 / $2,374.87
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,374.87 / $2,374.87 / $2,374.87
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.00 / $168.59 / $992.39
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$134.87 / $168.59 / $168.59
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,080.00 / $2,374.87 / $4,013.53