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Indiana rates for HCPCS 50574

Renal endoscopy through nephrotomy or pyelotomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with biopsy

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$630.96 / $3,801.89 / $5,623.41
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$524.81 / $575.44 / $1,174.90
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,265.80 / $8,709.64 / $11,220.18
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$562.34 / $812.83 / $1,258.93
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$537.03 / $562.34 / $630.96
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,238.72 / $2,238.72 / $2,238.72
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$549.54 / $758.58 / $1,202.26
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,905.46 / $2,884.03 / $4,265.80
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$524.81 / $660.69 / $1,096.48