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Arizona 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
$1,671.00 / $3,617.00 / $6,329.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,086.16 / $1,239.83 / $3,178.22
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,763.75 / $6,598.50 / $10,860.55
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$712.49 / $949.98 / $1,187.48
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,051.70 / $1,395.84 / $2,546.94
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,104.98 / $1,615.11 / $6,117.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,058.04 / $1,346.00 / $10,108.39
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,878.00 / $4,545.00 / $7,217.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,032.92 / $1,275.28 / $2,280.19