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Delaware 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
$6,907.00 / $6,907.00 / $6,907.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$704.70 / $717.73 / $732.45
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$639.51 / $898.37 / $1,243.10
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$703.82 / $889.89 / $1,628.93