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Mississippi 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
$660.69 / $1,819.70 / $2,818.38
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$660.69 / $741.31 / $1,905.46
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,570.40 / $2,570.40 / $2,570.40
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,584.89 / $1,584.89 / $1,584.89
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,630.27 / $2,630.27 / $5,370.32
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$691.83 / $1,148.15 / $1,698.24
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.36 / $32.36 / $33.11
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$977.24 / $4,168.69 / $10,232.93
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$676.08 / $933.25 / $1,621.81