go back

Montana 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
$432.00 / $1,813.12 / $2,218.04
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$535.26 / $535.26 / $535.26
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$503.79 / $580.25 / $697.82
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$328.18 / $785.85 / $808.34
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$350.85 / $539.74 / $746.46
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$616.59 / $724.80 / $1,147.92