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Pennsylvania 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
$594.00 / $2,371.00 / $7,799.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$496.07 / $556.28 / $711.44
Capital Blue Cross
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,058.35 / $6,182.00 / $17,094.48
Capital Blue Cross
Facility/Professional
Professional
Modifier
Low / Median / High Price
$491.78 / $784.63 / $1,067.59
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$537.57 / $735.45 / $1,146.14
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$645.23 / $853.51 / $853.51
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$641.00 / $2,371.00 / $8,017.00
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$496.07 / $593.71 / $2,843.00
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.00 / $767.20 / $1,371.20
Priority Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$559.54 / $740.29 / $1,285.14
UPMC Health Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$542.86 / $542.86 / $860.36
UPMC Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$525.17 / $546.83 / $860.36
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$814.00 / $2,391.00 / $4,789.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$553.69 / $695.40 / $1,163.77