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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

Facilitymedian $6,918 · 10th–90th $4,365–$12,3030%10%10th90th$6,918Professionalmedian $1,288 · 10th–90th $1,023–$3,0200%20%10th90th$1,288$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
$4,365.16 / $6,918.31 / $12,302.69
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,023.29 / $1,230.27 / $3,090.30
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,000.00 / $1,659.59 / $3,981.07
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,047.13 / $1,479.11 / $1,949.84
Horizon BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$109.65 / $109.65 / $109.65
Horizon BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$954.99 / $1,318.26 / $2,818.38
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,311.31 / $7,079.46 / $11,220.18
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$776.25 / $1,288.25 / $2,454.71