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Montana 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
$759.19 / $3,180.68 / $3,180.68
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$938.55 / $938.55 / $938.55
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$716.22 / $938.55 / $1,017.34
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$463.68 / $1,144.00 / $1,165.70
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$568.71 / $853.16 / $1,230.59
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$897.60 / $1,051.80 / $1,635.41