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Michigan 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
Facility
Modifier
Low / Median / High Price
$1,453.77 / $4,933.00 / $4,933.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,067.36 / $1,453.77 / $1,453.77
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,357.49 / $6,253.80 / $8,519.40
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$290.45 / $1,441.60 / $1,964.86
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,059.86 / $1,318.77 / $2,341.01
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,156.35 / $4,933.00 / $4,933.00
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,156.35 / $1,291.58 / $1,873.26
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$98.78 / $1,005.70 / $1,494.37
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,906.00 / $4,645.00 / $6,327.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,288.49 / $1,547.48 / $2,054.94