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Indiana 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

Facilitymedian $16,982 · 10th–90th $2,399–$25,7040%10%10th90th$16,982Professionalmedian $1,288 · 10th–90th $1,072–$2,2910%20%10th90th$1,288$500.0$1.0K$2.0K$5.0K$10.0K$20.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,288.25 / $2,344.23 / $4,897.79
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,071.52 / $1,202.26 / $2,187.76
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$9,120.11 / $18,620.87 / $26,302.68
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,071.52 / $1,548.82 / $2,398.83
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,122.02 / $1,148.15 / $1,318.26
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,174.90 / $1,862.09 / $2,398.83
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,023.29 / $1,445.44 / $2,570.40
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4,073.80 / $7,762.47 / $10,964.78
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,023.29 / $1,348.96 / $2,238.72