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Delaware 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
$7,244.36 / $7,244.36 / $7,244.36
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,380.38 / $1,698.24 / $3,630.78
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,258.93 / $1,737.80 / $2,511.89
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,230.27 / $1,584.89 / $2,511.89