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Virginia 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 $6,761 · 10th–90th $1,288–$18,1970%5%10th90th$6,761Professionalmedian $1,318 · 10th–90th $1,096–$2,6300%10%20%10th90th$1,318$1.0K$2.0K$5.0K$10.0K$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 / $3,630.78 / $14,791.08
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,096.48 / $1,288.25 / $2,630.27
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$8,709.64 / $16,218.10 / $21,877.62
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,096.48 / $1,445.44 / $2,089.30
CareFirst
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,174.90 / $1,445.44 / $1,995.26
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,071.52 / $1,479.11 / $2,344.23
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,000.00 / $1,202.26 / $3,090.30
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,479.11 / $1,862.09 / $2,691.53
Medcost
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,122.02 / $1,659.59 / $2,398.83
Sentara
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,047.13 / $1,548.82 / $5,495.41
Sentara
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,047.13 / $1,548.82 / $5,495.41
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5,495.41 / $8,317.64 / $17,378.01
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$977.24 / $1,479.11 / $2,344.23