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West Virginia rates for HCPCS 50400

Pyeloplasty Simple

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,090.49 / $1,090.49 / $1,400.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,022.83 / $1,181.27 / $1,363.82
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,225.53 / $1,359.98 / $1,481.72
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,317.08 / $1,317.08 / $1,317.08
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,311.59 / $1,311.59 / $1,311.59
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,120.77 / $1,646.36 / $10,108.39
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$948.82 / $1,314.58 / $2,036.86