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Maine rates for HCPCS 50125

Pyelotomy; with drainage, pyelostomy

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,258.79 / $1,258.79 / $1,451.46
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$17,783.47 / $23,063.27 / $26,006.75
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,185.39 / $1,307.83 / $2,005.37
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,184.14 / $1,468.22 / $2,103.48
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,090.53 / $1,404.52 / $2,154.60
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,258.79 / $1,258.79 / $1,451.46
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,090.53 / $1,456.19 / $2,149.50