go back

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
$562.34 / $691.83 / $1,230.27
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$489.78 / $851.14 / $1,148.15
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$691.83 / $758.58 / $1,230.27
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$616.60 / $741.31 / $1,122.02
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$575.44 / $758.58 / $1,778.28
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$602.56 / $812.83 / $1,202.26