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New Jersey 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
$930.80 / $5,975.00 / $11,332.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$930.80 / $1,239.83 / $1,931.04
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,059.86 / $1,744.83 / $3,667.73
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,307.47 / $1,775.19 / $2,115.07
Horizon BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$946.07 / $1,213.19 / $2,269.84
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,378.00 / $8,305.00 / $14,121.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$821.19 / $1,276.94 / $2,639.12