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Utah rates for HCPCS 50437

Dilation of existing tract, percutaneous, for an endourologic procedure including imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation, with postprocedure tube placement, when performed; including new access into the renal collecting system

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,454.71 / $3,715.35 / $6,025.60
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,128.61 / $6,025.60 / $13,489.63
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$323.59 / $398.11 / $588.84
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,137.96 / $5,128.61 / $8,317.64