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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
$602.56 / $776.25 / $1,479.11
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$933.25 / $933.25 / $933.25
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$724.44 / $933.25 / $1,023.29
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,023.29 / $1,023.29 / $1,258.93
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,023.29 / $1,023.29 / $1,258.93
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$524.81 / $891.25 / $1,148.15
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$79.43 / $616.60 / $1,230.27
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$891.25 / $1,023.29 / $1,513.56