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Wyoming 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
Professional
Modifier
Low / Median / High Price
$660.69 / $660.69 / $1,737.80
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,659.59 / $2,041.74 / $2,041.74
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$977.24 / $1,174.90 / $1,659.59
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,365.16 / $5,128.61 / $18,197.01
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$870.96 / $1,348.96 / $2,691.53