go back

New York 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
$1,678.45 / $3,996.00 / $10,296.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,233.99 / $1,700.62 / $3,558.31
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,100.00 / $7,264.00 / $12,697.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,138.41 / $1,488.12 / $3,381.15
CDPHP
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,966.01 / $1,966.01 / $37,499.62
CDPHP
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,966.01 / $1,966.01 / $1,966.01
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,582.97 / $1,582.97 / $7,227.90
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,203.95 / $2,414.94 / $5,424.36
Emblem Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$319.00 / $2,322.00 / $3,715.20
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,577.06 / $1,885.74 / $2,822.11
Excellus BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,076.03 / $1,690.67 / $2,513.40
Highmark BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$21,416.47 / $21,416.47 / $21,416.47
MVP Health Care
Facility/Professional
Facility
Modifier
Low / Median / High Price
$555.00 / $1,582.97 / $7,227.90
MVP Health Care
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,433.31 / $2,387.89 / $5,029.78
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,264.00 / $5,735.00 / $11,176.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,136.21 / $1,702.81 / $3,895.63
Univera
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,795.29 / $1,795.29 / $4,835.91
Univera
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,076.03 / $1,795.29 / $2,932.35