go back

Alaska rates for HCPCS Q2004

Bladder Calculi Irrig Sol

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$162.29 / $162.29 / $573.76
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$100.79 / $163.93 / $163.93
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$11.82 / $11.82 / $11.82
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$234.42 / $234.42 / $234.42
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$14.30 / $14.30 / $20.43
Premera BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$165.84 / $165.84 / $260.61
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$165.84 / $234.42 / $390.92
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$11.82 / $14.30 / $20.43
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$42.00 / $151.79 / $204.12