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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

Facilitymedian $4,467 · 10th–90th $1,862–$9,5500%5%10%10th90th$4,467Professionalmedian $1,349 · 10th–90th $1,072–$2,8840%10%10th90th$1,349$100.0$500.0$2.0K$10.0K

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
$1,698.24 / $4,265.80 / $8,511.38
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,047.13 / $1,318.26 / $2,884.03
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,238.72 / $4,786.30 / $10,000.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,174.90 / $1,412.54 / $2,290.87
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,047.13 / $1,174.90 / $1,819.70
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$512.86 / $1,513.56 / $2,511.89
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$54.95 / $2,041.74 / $7,079.46
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,202.26 / $1,819.70 / $10,000.00
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,137.96 / $3,019.95 / $6,456.54
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,148.15 / $1,584.89 / $2,630.27