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Montana 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)

Facilitymedian $2,399 · 10th–90th $2,188–$2,6300%50%10th90th$2,399Professionalmedian $2,344 · 10th–90th $1,413–$5,7540%10%20%10th90th$2,344$100.0$200.0$500.0$1.0K$2.0K$5.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,412.54 / $1,995.26 / $5,754.40
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,187.76 / $2,187.76 / $2,187.76
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,584.89 / $2,187.76 / $2,344.23
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,344.23 / $2,398.83 / $2,630.27
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,344.23 / $2,398.83 / $2,630.27
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,230.27 / $1,995.26 / $2,754.23
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $1,584.89 / $3,019.95
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,621.81 / $1,621.81 / $1,621.81
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,905.46 / $2,398.83 / $3,801.89