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Maine rates for HCPCS 50557

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

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$354.81 / $446.68 / $794.33
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$331.13 / $537.03 / $741.31
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$426.58 / $562.34 / $758.58
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$380.19 / $549.54 / $870.96
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$389.05 / $537.03 / $1,380.38
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$389.05 / $575.44 / $891.25