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Missouri rates for HCPCS L8604

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

Facilitymedian $2,570 · 10th–90th $2,399–$6,1660%20%40%10th90th$2,570Professionalmedian $2,399 · 10th–90th $123–$2,3990%50%10th$2,399$100.0$200.0$500.0$1.0K$2.0K$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
$2,398.83 / $4,677.35 / $6,165.95
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,398.83 / $2,398.83 / $2,398.83
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$123.03 / $123.03 / $128.82
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,398.83 / $2,454.71 / $4,897.79