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Maryland 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
Professional
Modifier
Low / Median / High Price
$1,419.60 / $1,472.67 / $5,559.88
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,601.41 / $1,603.18 / $1,832.43
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,350.85 / $1,861.06 / $4,311.91
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,428.51 / $1,899.92 / $3,038.20
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,210.71 / $1,656.01 / $3,196.93
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,113.35 / $1,642.79 / $2,043.63