go back

Montana 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
$706.46 / $2,959.12 / $2,959.12
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$873.35 / $873.35 / $873.35
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$666.63 / $873.35 / $946.33
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$431.90 / $1,068.59 / $1,088.53
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$529.25 / $793.95 / $1,145.20
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$838.44 / $962.29 / $1,522.54