go back

Kansas rates for HCPCS Q2004

Irrigation solution for treatment of bladder calculi, for example renacidin, per 500 ml

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$97.72 / $97.72 / $120.23
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$97.72 / $97.72 / $120.23
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$123.03 / $125.89 / $128.82
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$107.15 / $107.15 / $107.15
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$11.75 / $11.75 / $11.75
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$11.48 / $114.82 / $120.23
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$102.33 / $102.33 / $120.23
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$11.75 / $11.75 / $13.80
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$102.33 / $102.33 / $120.23