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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
$1,470.24 / $1,470.24 / $1,636.40
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$17,783.47 / $23,063.27 / $26,006.75
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,380.99 / $1,524.75 / $2,336.31
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,385.51 / $1,710.47 / $2,450.55
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,270.50 / $1,636.30 / $2,510.17
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,470.24 / $1,470.24 / $1,636.40
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,387.00 / $1,797.46 / $2,263.83