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Montana 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

Facilitymedian $912 · 10th–90th $891–$1,0960%50%10th90th$912Professionalmedian $759 · 10th–90th $537–$1,7780%10%20%10th90th$759$100.0$200.0$500.0$1.0K$2.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$537.03 / $676.08 / $1,778.28
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$812.83 / $812.83 / $812.83
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$630.96 / $812.83 / $891.25
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$891.25 / $912.01 / $1,096.48
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$891.25 / $912.01 / $1,096.48
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$467.74 / $794.33 / $1,023.29
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $630.96 / $1,148.15
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$616.60 / $616.60 / $1,412.54
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$724.44 / $912.01 / $1,445.44