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South Dakota 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 $1,820 · 10th–90th $1,318–$4,3650%20%10th90th$1,820Professionalmedian $1,778 · 10th–90th $1,318–$3,7150%20%10th90th$1,778$2.0K$5.0K$10.0K

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
Facility
Modifier
Typical Low / Median / Typical High
$1,318.26 / $1,318.26 / $4,365.16
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,174.90 / $1,412.54 / $1,778.28
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,019.95 / $3,162.28 / $3,981.07
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,698.24 / $2,344.23 / $3,630.78
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,288.25 / $2,511.89 / $12,302.69
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,884.03 / $3,019.95 / $3,311.31
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,884.03 / $2,884.03 / $2,884.03
Sanford Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,862.09 / $2,344.23 / $2,691.53
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,162.28 / $3,162.28 / $3,162.28
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,412.54 / $2,754.23 / $3,890.45
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,691.53 / $3,162.28 / $3,311.31