go back

Wyoming 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
$1,390.94 / $1,390.94 / $1,390.94
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,713.00 / $3,256.00 / $4,069.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,893.57 / $2,324.83 / $3,274.80
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,200.00 / $4,200.00 / $14,634.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,204.94 / $3,127.76 / $5,456.86