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Minnesota 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
$524.81 / $524.81 / $2,238.72
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$524.81 / $630.96 / $1,047.13
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,348.96 / $6,606.93 / $15,848.93
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$831.76 / $1,258.93 / $1,995.26
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,412.54 / $1,995.26 / $4,786.30
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,122.02 / $1,698.24 / $2,570.40
Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,513.56 / $1,905.46 / $3,715.35
Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,023.29 / $1,445.44 / $2,137.96
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$691.83 / $1,096.48 / $3,981.07
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$691.83 / $1,148.15 / $2,454.71
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,000.00 / $2,884.03 / $8,912.51
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$660.69 / $1,148.15 / $2,187.76