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Tennessee 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
Facility
Modifier
Low / Median / High Price
$575.44 / $2,290.87 / $4,073.80
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$562.34 / $691.83 / $1,148.15
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,737.80 / $5,370.32 / $9,332.54
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$645.65 / $891.25 / $1,445.44
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,311.31 / $3,311.31 / $3,311.31
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$602.56 / $831.76 / $1,230.27
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$54.95 / $14,454.40 / $14,454.40
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,365.16 / $5,011.87 / $5,011.87
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,202.26 / $2,290.87 / $4,073.80
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$575.44 / $831.76 / $1,318.26