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Nebraska rates for HCPCS L8604

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

Facilitymedian $4,074 · 10th–90th $2,399–$25,7040%10%20%10th90th$4,074Professionalmedian $2,399 · 10th–90th $95–$2,5120%50%10th90th$2,399$100.0$500.0$2.0K$10.0K

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,398.83 / $9,120.11 / $25,703.96
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$95.50 / $2,398.83 / $2,511.89
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,398.83 / $3,162.28 / $6,165.95
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$190.55 / $2,454.71 / $4,365.16
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,398.83 / $2,398.83 / $2,398.83
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$69.18 / $69.18 / $83.18