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Kentucky 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
$702.26 / $864.32 / $8,229.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$702.26 / $723.00 / $865.58
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7,212.00 / $9,015.00 / $11,253.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$654.13 / $784.52 / $1,112.00
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$669.49 / $918.92 / $1,060.03
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$715.79 / $918.92 / $1,476.83
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$728.83 / $805.64 / $805.64
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$695.57 / $1,018.70 / $1,554.70
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.34 / $32.34 / $32.34
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$842.00 / $4,539.00 / $10,113.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$692.75 / $1,003.79 / $1,408.87