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Michigan rates for HCPCS 50630

Ureterolithotomy; lower one-third of ureter

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,131.86 / $4,933.00 / $5,757.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$831.36 / $1,131.86 / $1,131.86
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,218.64 / $4,924.42 / $6,708.42
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$235.52 / $1,332.10 / $2,098.07
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$825.86 / $1,029.29 / $1,822.50
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$901.03 / $4,933.00 / $5,757.00
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$901.03 / $1,006.11 / $1,461.73
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$65.66 / $786.47 / $1,180.66
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,906.00 / $4,645.00 / $6,327.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$983.43 / $1,204.23 / $1,510.71