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South Dakota rates for HCPCS 50553

Renal endoscopy through established nephrostomy or pyelostomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with ureteral catheterization, with or without dilation of ureter

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$293.62 / $371.56 / $371.56
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$380.59 / $600.41 / $988.20
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$692.00 / $950.02 / $4,412.80
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$416.02 / $602.26 / $756.23
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,714.00 / $2,714.00 / $2,714.00