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Alaska rates for HCPCS 50125

Pyelotomy; with drainage, pyelostomy

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,913.43 / $10,900.00 / $14,552.94
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,607.60 / $4,607.60 / $6,401.21
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,390.56 / $3,390.56 / $3,390.56
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,237.43 / $4,607.60 / $6,588.87
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,381.50 / $6,184.50 / $8,097.70
Premera BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,681.25 / $4,270.25 / $6,263.40
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,237.43 / $4,607.60 / $6,588.87
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,350.43 / $4,252.50 / $6,339.89
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,712.46 / $4,068.69 / $6,265.02