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Montana 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

Facilitymedian $955 · 10th–90th $933–$1,1750%50%10th90th$955Professionalmedian $813 · 10th–90th $562–$1,8620%10%20%10th90th$813$100.0$500.0$2.0K$10.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$562.34 / $724.44 / $1,862.09
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$870.96 / $870.96 / $870.96
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$660.69 / $870.96 / $933.25
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$933.25 / $954.99 / $1,174.90
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$933.25 / $954.99 / $1,174.90
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$489.78 / $831.76 / $1,096.48
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $660.69 / $1,230.27
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$645.65 / $645.65 / $19,498.45
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$758.58 / $954.99 / $1,513.56