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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
$616.60 / $3,801.89 / $5,623.41
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$524.81 / $575.44 / $1,348.96
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8,317.64 / $19,952.62 / $27,542.29
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$562.34 / $851.14 / $1,288.25
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$537.03 / $562.34 / $630.96
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$549.54 / $776.25 / $1,230.27
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,570.40 / $4,168.69 / $7,943.28
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$524.81 / $660.69 / $1,096.48