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Pennsylvania 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
Facility
Modifier
Low / Median / High Price
$450.16 / $2,070.00 / $7,629.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$304.07 / $371.04 / $494.05
Capital Blue Cross
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,431.95 / $7,827.00 / $19,139.18
Capital Blue Cross
Facility/Professional
Professional
Modifier
Low / Median / High Price
$370.61 / $533.29 / $779.41
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$367.81 / $504.51 / $781.03
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$493.58 / $653.29 / $659.37
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$617.00 / $2,326.00 / $8,017.00
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$314.42 / $412.27 / $1,541.00
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.00 / $995.10 / $1,102.00
Priority Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$371.34 / $512.92 / $815.23
UPMC Health Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$333.30 / $406.65 / $963.15
UPMC Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$333.30 / $395.59 / $630.71
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,334.00 / $2,824.00 / $5,678.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$416.38 / $527.54 / $854.74