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Pennsylvania 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 $6,166 · 10th–90th $1,230–$19,0550%10%20%10th90th$6,166Professionalmedian $1,230 · 10th–90th $1,023–$2,2390%20%40%10th90th$1,230$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
$1,230.27 / $6,606.93 / $19,054.61
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,023.29 / $1,230.27 / $2,238.72
Capital Blue Cross
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$20,417.38 / $21,379.62 / $57,543.99
Capital Blue Cross
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,023.29 / $1,479.11 / $2,137.96
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$512.86 / $1,380.38 / $2,238.72
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,621.81 / $1,621.81 / $1,737.80
Geisinger
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,047.13 / $1,445.44 / $2,238.72
Highmark BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$13,489.63 / $16,595.87 / $18,620.87
Martin's Point
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$831.76 / $3,981.07 / $8,317.64
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,023.29 / $1,230.27 / $2,137.96
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,445.44 / $1,737.80 / $2,398.83
UPMC Health Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,122.02 / $1,122.02 / $1,318.26
UPMC Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,096.48 / $1,122.02 / $1,174.90
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,089.30 / $3,388.44 / $6,456.54
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$977.24 / $1,348.96 / $2,344.23