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California 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
$1,555.64 / $9,639.00 / $20,509.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,425.30 / $1,555.64 / $5,914.98
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,314.00 / $10,163.93 / $20,418.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,602.10 / $2,156.05 / $4,105.99
Blue Shield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$63.50 / $100.00 / $5,485.17
Blue Shield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$977.31 / $1,498.59 / $3,694.65
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,353.42 / $1,822.20 / $5,543.91
Contra Costa Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,096.42 / $1,538.39 / $1,846.07
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,384.55 / $1,771.38 / $3,212.41
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$55.00 / $10,228.79 / $12,945.04
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$11,530.13 / $12,225.55 / $12,628.99
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,476.15 / $1,907.61 / $2,519.40
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,380.28 / $1,828.48 / $3,947.30
Sutter Health Plus
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,551.71 / $4,551.71 / $4,551.71
The Alliance
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,096.42 / $1,644.64 / $2,074.02
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,110.00 / $9,707.00 / $21,278.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,163.82 / $1,699.96 / $4,451.26