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Oklahoma 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
$1,295.49 / $3,684.00 / $18,600.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,295.49 / $1,295.49 / $1,363.82
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7,701.16 / $12,172.15 / $19,381.03
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,501.69 / $1,501.69 / $1,533.60
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,180.92 / $1,566.68 / $1,838.43
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,175.98 / $1,813.69 / $6,710.71
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,091.67 / $1,470.45 / $10,108.39
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,091.00 / $4,054.00 / $7,077.94
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$970.38 / $1,330.42 / $2,132.40