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North Carolina 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
$1,359.31 / $2,157.17 / $14,890.60
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,359.31 / $1,425.30 / $3,775.71
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,926.44 / $2,533.19 / $3,548.55
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,547.85 / $2,321.48 / $3,714.85
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,359.31 / $1,906.28 / $3,440.82
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,906.28 / $1,906.28 / $3,445.76
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.00 / $2,344.90 / $3,438.60
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,366.00 / $9,541.00 / $14,589.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,368.08 / $1,959.71 / $4,152.22
Wellcare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$55.00 / $10,228.79 / $12,661.36
Wellcare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$11,530.13 / $12,628.99 / $12,628.99