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Maine 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
$720.94 / $720.94 / $815.70
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$670.65 / $752.27 / $1,135.81
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$702.02 / $832.92 / $1,193.31
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$617.66 / $795.50 / $1,220.33
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$720.94 / $720.94 / $815.70
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$649.36 / $838.10 / $1,096.93