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Pennsylvania rates for HCPCS Q2004

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

Facilitymedian $174 · 10th–90th $102–$2880%20%10th90th$174Professionalmedian $102 · 10th–90th $98–$1020%50%10th$102$10.0$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
$102.33 / $239.88 / $288.40
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$97.72 / $102.33 / $102.33
Capital Blue Cross
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$29.51 / $34.67 / $5,011.87
Capital Blue Cross
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.90 / $30.90 / $30.90
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.30 / $12.30 / $12.30
Martin's Point
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$102.33 / $154.88 / $154.88
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$97.72 / $102.33 / $102.33
UPMC Health Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5.89 / $17.38 / $25.70
UPMC Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$5.89 / $17.38 / $74.13
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$147.91 / $147.91 / $147.91
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$102.33 / $102.33 / $141.25