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Wisconsin 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
$316.23 / $630.96 / $1,905.46
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,165.95 / $10,232.93 / $17,378.01
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,000.00 / $1,174.90 / $1,862.09
DeanCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$316.23 / $776.25 / $3,715.35
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$309.03 / $794.33 / $8,317.64
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$446.68 / $912.01 / $1,380.38
Quartz
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9,772.37 / $14,454.40 / $14,454.40
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,897.79 / $7,413.10 / $9,120.11