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Florida 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
$1,012.47 / $5,839.00 / $11,576.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$978.92 / $1,076.58 / $1,405.78
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$323.00 / $400.00 / $10,000.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$973.00 / $1,532.71 / $2,496.13
Florida Blue
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9,624.00 / $21,162.00 / $32,051.00
Florida Blue
Facility/Professional
Professional
Modifier
Low / Median / High Price
$795.02 / $851.81 / $1,498.26
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$106.60 / $1,094.48 / $1,544.75
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,637.00 / $8,136.00 / $12,748.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$967.82 / $1,402.01 / $2,352.46
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$882.40 / $882.40 / $882.40