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Maine 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
Professional
Modifier
Low / Median / High Price
$679.71 / $679.71 / $769.76
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$632.98 / $709.10 / $1,071.80
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$661.92 / $785.56 / $1,125.46
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$582.85 / $750.66 / $1,151.56
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$679.71 / $679.71 / $769.76
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$570.50 / $766.52 / $1,035.24