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Alaska rates for HCPCS 50400

Pyeloplasty (Foley Y-pyeloplasty), plastic operation on renal pelvis, with or without plastic operation on ureter, nephropexy, nephrostomy, pyelostomy, or ureteral splinting; simple

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,548.13 / $12,022.64 / $16,595.87
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,096.48 / $1,479.11 / $5,370.32
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,981.07 / $3,981.07 / $3,981.07
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,174.90 / $1,905.46 / $7,585.78
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,344.23 / $3,311.31 / $8,128.31
Premera BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,677.35 / $4,677.35 / $7,244.36
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,905.46 / $5,370.32 / $7,762.47
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.26 / $1,122.02 / $3,981.07
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,951.21 / $3,235.94 / $7,413.10