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California rates for HCPCS 50630

Ureterolithotomy; lower one-third of ureter

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,616.00 / $9,006.00 / $19,860.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$841.68 / $951.62 / $4,695.24
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,738.00 / $8,530.00 / $17,774.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,014.47 / $1,404.24 / $2,598.98
Blue Shield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$64.20 / $100.00 / $5,620.13
Blue Shield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$629.26 / $968.24 / $2,380.21
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$867.26 / $1,154.90 / $3,515.81
Contra Costa Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$744.60 / $992.51 / $1,191.01
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$891.57 / $1,141.61 / $2,027.26
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$55.00 / $5,741.40 / $7,270.20
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6,487.76 / $6,633.76 / $7,402.58
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$950.63 / $1,222.69 / $1,805.50
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$883.42 / $1,165.81 / $2,530.76
Sutter Health Plus
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,913.30 / $2,913.30 / $2,913.30
The Alliance
Facility/Professional
Professional
Modifier
Low / Median / High Price
$744.60 / $1,101.83 / $1,408.50
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,047.00 / $5,067.00 / $20,279.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$744.02 / $1,122.56 / $3,004.96