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South Dakota rates for HCPCS 50555

Renal endoscopy through established nephrostomy or pyelostomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with biopsy

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$316.23 / $398.11 / $4,365.16
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$426.58 / $645.65 / $1,047.13
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$741.31 / $794.33 / $954.99
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$512.86 / $660.69 / $812.83
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,995.26 / $1,995.26 / $1,995.26