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Indiana 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
$520.78 / $1,338.40 / $5,634.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$520.78 / $556.28 / $734.30
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,429.00 / $10,338.00 / $26,304.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$607.27 / $854.00 / $1,178.52
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$537.83 / $759.29 / $1,138.94
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$516.30 / $632.74 / $911.15
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,405.61 / $6,405.61 / $6,405.61
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$542.91 / $759.88 / $1,202.18
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,400.00 / $4,261.00 / $8,011.13
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$546.08 / $679.46 / $1,088.78