go back

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
$7,244.36 / $7,244.36 / $7,244.36
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$707.95 / $870.96 / $1,819.70
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$645.65 / $891.25 / $1,288.25
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,995.26 / $1,995.26 / $1,995.26
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$691.83 / $831.76 / $1,288.25