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New Jersey rates for HCPCS L8604

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

Facilitymedian $3,890 · 10th–90th $2,512–$5,7540%50%10th90th$3,890Professionalmedian $2,399 · 10th–90th $95–$2,5120%50%10th90th$2,399$50.0$200.0$1.0K$5.0K$20.0K

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 / $3,890.45 / $5,754.40
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$323.59 / $2,398.83 / $2,511.89
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$44.67 / $44.67 / $38,018.94