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Alaska rates for HCPCS 50572

Renal endoscopy through nephrotomy or pyelotomy, 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
$2,464.00 / $6,782.00 / $13,413.92
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,499.71 / $2,499.71 / $3,510.48
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,854.73 / $1,854.73 / $1,854.73
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$670.45 / $2,499.71 / $3,574.60
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,272.83 / $3,305.40 / $4,386.20
Premera BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,967.50 / $2,282.30 / $3,399.00
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$670.45 / $2,499.71 / $3,574.60
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$731.50 / $2,301.00 / $3,434.20
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,329.16 / $2,225.67 / $3,435.79