go back

Nebraska 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
$121.43 / $233.40 / $268.41
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$97.14 / $97.14 / $163.02
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12.26 / $12.77 / $12.91
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$16.50 / $16.50 / $20.63
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$118.46 / $184.57 / $734.60
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$91.07 / $101.19 / $121.43
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$17.51 / $23.51 / $286.49
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$17.19 / $23.39 / $39.15
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$91.07 / $101.19 / $111.31