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Alaska rates for HCPCS 50405

Pyeloplasty (Foley Y-pyeloplasty), plastic operation on renal pelvis, with or without plastic operation on ureter, nephropexy, nephrostomy, pyelostomy, or ureteral splinting; complicated (congenital kidney abnormality, secondary pyeloplasty, solitary kidney, calycoplasty)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,265.80 / $14,125.38 / $26,915.35
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,318.26 / $1,778.28 / $6,606.93
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,786.30 / $4,786.30 / $4,786.30
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,412.54 / $2,290.87 / $9,332.54
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,090.30 / $3,981.07 / $9,772.37
Premera BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5,623.41 / $5,623.41 / $8,709.64
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,290.87 / $6,606.93 / $9,332.54
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.26 / $1,348.96 / $4,786.30
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,548.13 / $3,890.45 / $8,912.51