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Idaho 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
$4,500.00 / $4,500.00 / $5,519.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,425.30 / $1,809.70 / $3,161.95
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,957.98 / $2,396.82 / $2,675.90
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,577.06 / $2,773.79 / $3,351.67
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,225.07 / $2,359.92 / $2,697.06
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.34 / $1,947.28 / $2,449.80
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,119.14 / $2,119.14 / $2,608.27
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9,360.00 / $16,762.00 / $17,870.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,454.77 / $1,860.30 / $2,982.94