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Michigan 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
$2,041.74 / $2,041.74 / $4,897.79
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$524.81 / $588.84 / $1,023.29
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$165.96 / $165.96 / $1,258.93
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$416.87 / $870.96 / $1,258.93
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$501.19 / $660.69 / $933.25
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$707.95 / $2,041.74 / $4,897.79
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$537.03 / $645.65 / $891.25
Priority Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$602.56 / $660.69 / $933.25
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$954.99 / $2,691.53 / $7,943.28
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$588.84 / $724.44 / $977.24