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Texas 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
$554.53 / $2,172.00 / $7,513.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$506.87 / $554.53 / $773.54
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$523.14 / $896.01 / $1,951.32
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$478.64 / $605.03 / $659.02
Christus
Facility/Professional
Facility
Modifier
Low / Median / High Price
$458.02 / $458.02 / $458.02
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$453.50 / $453.50 / $453.50
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$545.84 / $713.03 / $1,095.98
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$55.00 / $55.00 / $4,777.60
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,821.36 / $3,905.52 / $4,349.03
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$508.55 / $690.14 / $1,176.59
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$661.87 / $778.97 / $916.43
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$809.70 / $809.70 / $809.70
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$508.55 / $702.48 / $1,247.69
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$548.48 / $731.35 / $1,115.08
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$369.00 / $1,529.00 / $3,287.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$442.89 / $608.97 / $941.14
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$434.53 / $499.06 / $686.80