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Pennsylvania 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
$1,014.68 / $3,839.00 / $8,247.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,014.68 / $1,140.28 / $1,453.77
Capital Blue Cross
Facility/Professional
Facility
Modifier
Low / Median / High Price
$13,531.00 / $27,840.00 / $46,480.74
Capital Blue Cross
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,008.36 / $1,606.42 / $2,166.44
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,103.33 / $1,476.38 / $2,325.98
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,328.80 / $1,757.87 / $1,762.39
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$832.00 / $4,761.00 / $8,247.00
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,014.68 / $1,214.64 / $2,938.51
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.00 / $1,558.10 / $2,830.60
Priority Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,117.38 / $1,491.17 / $2,459.11
UPMC Health Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,111.42 / $1,111.42 / $1,434.25
UPMC Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,077.10 / $1,117.53 / $1,434.25
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$625.00 / $2,391.00 / $6,322.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,092.59 / $1,390.87 / $2,310.59