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New Jersey 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
$1,129.77 / $5,982.00 / $11,298.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,129.77 / $1,495.14 / $2,330.13
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,236.77 / $2,100.86 / $4,430.03
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,577.06 / $2,140.19 / $2,551.03
Horizon BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,134.40 / $1,521.44 / $2,538.54
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,378.00 / $8,305.00 / $14,121.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,025.98 / $1,537.15 / $3,296.37