go back

Arizona rates for HCPCS 50576

Renal endoscopy through nephrotomy or pyelotomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with fulguration and/or incision, with or without biopsy

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,170.00 / $2,736.07 / $5,506.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$524.38 / $570.80 / $2,951.65
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,763.75 / $6,598.50 / $10,860.55
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$343.69 / $458.26 / $572.82
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8,805.45 / $8,805.45 / $8,805.45
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$523.04 / $690.54 / $1,241.07
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$532.78 / $768.04 / $3,134.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$518.94 / $666.25 / $4,139.04
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,584.00 / $2,567.00 / $8,179.80
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$513.10 / $618.26 / $1,076.76