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Maine rates for HCPCS 50580

Renal endoscopy through nephrotomy or pyelotomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with removal of foreign body or calculus

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$776.88 / $776.88 / $876.14
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$722.89 / $810.24 / $1,222.29
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$757.00 / $897.24 / $1,285.45
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$664.69 / $856.06 / $1,313.25
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$654.97 / $776.88 / $876.14
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$739.90 / $907.61 / $1,181.98