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Maine rates for HCPCS 50540

Symphysiotomy for horseshoe kidney with or without pyeloplasty and/or other plastic procedure, unilateral or bilateral (1 operation)

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,174.90 / $1,412.54 / $2,570.40
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$18,197.01 / $19,498.45 / $26,302.68
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,023.29 / $1,737.80 / $2,344.23
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,348.96 / $1,548.82 / $2,511.89
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,258.93 / $1,548.82 / $2,290.87
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,174.90 / $1,584.89 / $3,548.13
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,148.15 / $1,621.81 / $2,290.87