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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
$295.12 / $389.05 / $7,585.78
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$398.11 / $616.60 / $977.24
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$676.08 / $741.31 / $891.25
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$446.68 / $602.56 / $758.58
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,691.53 / $2,691.53 / $2,691.53