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Ohio 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 $8,128 · 10th–90th $1,514$16,5960%10%20%10th90th$8,128Professionalmedian $1,318 · 10th–90th $1,047$2,7540%20%40%10th90th$1,318$10.0$50.0$200.0$1.0K$5.0K$20.0K

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
$1,258.93 / $8,912.51 / $11,748.98
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,071.52 / $1,230.27 / $3,801.89
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,511.89 / $9,549.93 / $20,417.38
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,047.13 / $1,318.26 / $2,290.87
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,096.48 / $1,148.15 / $1,318.26
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$977.24 / $1,479.11 / $21,379.62
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$478.63 / $1,513.56 / $2,290.87
Medical Mutual of Ohio
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$21,379.62 / $21,379.62 / $21,379.62
Medical Mutual of Ohio
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$457.09 / $1,513.56 / $2,344.23
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $32.36 / $33.11
SummaCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$100.00 / $100.00 / $100.00
SummaCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,071.52 / $1,258.93 / $2,344.23
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,548.13 / $6,456.54 / $8,511.38
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,000.00 / $1,348.96 / $2,137.96