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Vermont 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
Professional
Modifier
Low / Median / High Price
$1,445.44 / $1,778.28 / $2,511.89
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,202.26 / $1,949.84 / $3,162.28
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,479.11 / $1,995.26 / $5,754.40