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North Dakota 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 / $707.95 / $8,511.38
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$660.69 / $724.44 / $1,023.29
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,230.27 / $1,513.56 / $1,819.70
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$912.01 / $1,318.26 / $2,137.96
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$707.95 / $1,047.13 / $2,137.96
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$741.31 / $1,288.25 / $1,548.82
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,370.32 / $5,888.44 / $5,888.44
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$741.31 / $1,288.25 / $1,778.28