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Maine 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
Professional
Modifier
Low / Median / High Price
$722.76 / $722.76 / $818.25
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$672.67 / $754.15 / $1,138.53
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$703.79 / $835.02 / $1,196.31
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$619.14 / $797.40 / $1,223.26
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$722.76 / $722.76 / $818.25
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$697.76 / $928.89 / $1,120.28