go back

Maine rates for HCPCS 50620

Ureterolithotomy; middle one-third of ureter

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,158.42 / $1,158.42 / $1,303.47
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$12,065.14 / $15,647.20 / $17,644.18
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,089.40 / $1,200.78 / $1,843.31
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,080.42 / $1,348.37 / $1,931.77
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,002.40 / $1,291.02 / $1,980.49
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,158.42 / $1,158.42 / $1,303.47
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$960.74 / $1,330.35 / $1,786.88