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Utah 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 $4,467 · 10th–90th $1,622–$16,9820%20%10th90th$4,467Professionalmedian $1,479 · 10th–90th $1,096–$2,6300%20%10th90th$1,479$50.0$200.0$1.0K$5.0K

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
$1,621.81 / $4,168.69 / $16,982.44
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,096.48 / $1,230.27 / $2,630.27
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,348.96 / $1,621.81 / $2,454.71
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $2,818.38
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,479.11 / $2,041.74 / $5,888.44
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,230.27 / $2,089.30 / $3,162.28
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,000.00 / $1,659.59 / $4,677.35
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,202.26 / $5,128.61 / $8,317.64
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,096.48 / $1,412.54 / $2,398.83