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Nebraska 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
$4,241.22 / $10,431.19 / $24,068.03
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,058.40 / $1,058.40 / $6,106.13
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9,823.60 / $13,313.50 / $24,992.84
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,025.13 / $1,747.39 / $2,329.84
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,136.28 / $2,654.80 / $3,536.33
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,127.47 / $1,928.92 / $8,816.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,502.43 / $2,677.75 / $10,108.39
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,989.00 / $2,515.28 / $3,536.33
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,802.53 / $2,515.28 / $3,517.49
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.00 / $1,872.00 / $2,853.10
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,341.00 / $7,441.00 / $8,816.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,502.43 / $2,544.39 / $2,733.85