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Alabama rates for HCPCS 50575

Renal endoscopy through nephrotomy or pyelotomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with endopyelotomy (includes cystoscopy, ureteroscopy, dilation of ureter and ureteral pelvic junction, incision of ureteral pelvic junction and insertion of endopyelotomy stent)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,096.48 / $1,445.44 / $2,398.83
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$660.69 / $870.96 / $1,445.44
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,073.80 / $4,786.30 / $6,456.54
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$724.44 / $1,047.13 / $1,230.27
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$524.81 / $891.25 / $1,288.25
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,479.11 / $4,365.16 / $6,918.31
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$537.03 / $758.58 / $1,174.90