go back

Oregon rates for HCPCS L8604

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

Facilitymedian $2,399 · 10th–90th $95–$3,2360%50%10th90th$2,399Professionalmedian $2,399 · 10th–90th $95–$2,5120%50%10th90th$2,399$100.0$200.0$500.0$1.0K$2.0K

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
$95.50 / $95.50 / $2,398.83
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$95.50 / $2,398.83 / $2,511.89
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,398.83 / $2,398.83 / $3,388.44
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$95.50 / $2,398.83 / $2,511.89
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,398.83 / $2,398.83 / $3,548.13
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$60.26 / $79.43 / $79.43