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Massachusetts 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 $3,090 · 10th–90th $1,072–$6,4570%5%10%10th90th$3,090Professionalmedian $1,413 · 10th–90th $1,072–$3,0900%10%10th90th$1,413$100.0$500.0$2.0K$10.0K$50.0K

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
$1,174.90 / $3,388.44 / $5,623.41
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,071.52 / $1,258.93 / $3,090.30
AllWays Health Partners
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$56.23 / $3,235.94 / $7,585.78
AllWays Health Partners
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$891.25 / $1,659.59 / $10,471.29
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$616.60 / $1,778.28 / $3,981.07
Fallon Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$630.96 / $1,288.25 / $3,311.31
Fallon Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$602.56 / $1,122.02 / $1,698.24
Harvard Pilgrim
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,398.83 / $5,248.07 / $11,220.18
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,071.52 / $1,819.70 / $2,754.23
Health New England
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5,888.44 / $5,888.44 / $5,888.44
Mass General Brigham
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$56.23 / $3,235.94 / $7,585.78
Mass General Brigham
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$891.25 / $1,659.59 / $10,471.29
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,041.74 / $5,248.07 / $8,709.64
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,202.26 / $1,737.80 / $3,235.94