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Nebraska 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
$4,241.22 / $10,431.19 / $24,068.03
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,277.31 / $1,277.31 / $7,335.79
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9,823.60 / $13,313.50 / $24,992.84
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,236.50 / $2,107.67 / $2,810.23
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,576.75 / $3,202.18 / $4,267.43
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,359.55 / $2,318.38 / $8,816.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,808.73 / $3,231.59 / $12,225.55
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,391.00 / $3,034.19 / $4,267.43
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,176.50 / $3,034.19 / $4,242.25
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
$5,341.00 / $7,441.00 / $8,816.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,875.72 / $3,122.27 / $3,825.49