go back

Nebraska 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 / $25,512.96
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
$2,413.06 / $3,498.26 / $6,139.22
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,137.38 / $2,374.87 / $4,156.02
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,374.87 / $2,374.87 / $2,374.87