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West Virginia 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
$531.63 / $531.63 / $1,400.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$496.07 / $556.28 / $641.01
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$594.84 / $662.24 / $721.53
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$641.36 / $641.36 / $641.36
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$635.94 / $635.94 / $635.94
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$540.54 / $814.08 / $3,417.21
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$461.94 / $686.85 / $1,013.92