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Maryland 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
Professional
Modifier
Low / Median / High Price
$524.81 / $645.65 / $1,778.28
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$537.03 / $588.84 / $812.83
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,011.87 / $5,011.87 / $5,011.87
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$537.03 / $741.31 / $1,584.89
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$512.86 / $588.84 / $977.24
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$707.95 / $707.95 / $707.95
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$489.78 / $691.83 / $1,122.02
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$446.68 / $660.69 / $776.25