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Missouri 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
$1,386.84 / $4,261.00 / $12,154.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,054.03 / $1,309.91 / $2,338.58
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,224.00 / $4,490.00 / $11,288.19
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,162.49 / $1,415.00 / $2,270.48
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,024.35 / $1,650.50 / $2,950.89
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$940.72 / $1,954.25 / $5,698.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,304.59 / $2,112.64 / $10,108.39
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,708.00 / $3,502.00 / $6,854.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,212.97 / $1,606.66 / $2,669.85