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New Hampshire 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
$100.00 / $2,195.48 / $8,965.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$543.04 / $769.76 / $2,195.48
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,223.09 / $1,359.00 / $3,300.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$639.11 / $993.83 / $1,502.77
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$665.56 / $1,086.74 / $1,719.03
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$582.85 / $1,156.26 / $1,919.97
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8,035.00 / $8,035.00 / $8,035.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$582.85 / $866.05 / $1,762.65
Well Sense
Facility/Professional
Professional
Modifier
Low / Median / High Price
$413.92 / $455.31 / $579.49