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New York rates for HCPCS L8604

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

Facilitymedian $4,169 · 10th–90th $2,754–$22,3870%10%20%10th90th$4,169Professionalmedian $2,399 · 10th–90th $59–$2,5120%20%40%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
$2,754.23 / $9,549.93 / $22,387.21
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,089.30 / $2,398.83 / $2,511.89
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$53.70 / $66.07 / $117.49
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$64.57 / $50,118.72 / $53,703.18
Excellus BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,388.44 / $3,467.37 / $3,467.37
Excellus BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,388.44 / $3,388.44 / $3,467.37
MVP Health Care
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$50,118.72 / $53,703.18 / $75,857.76
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$44.67 / $44.67 / $64.57
Univera
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,388.44 / $3,467.37 / $3,801.89
Univera
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,388.44 / $3,388.44 / $3,467.37