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Arizona rates for HCPCS 50684

Injection procedure for ureterography or ureteropyelography through ureterostomy or indwelling ureteral catheter

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,038.00 / $2,640.00 / $6,329.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$47.76 / $91.54 / $171.06
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$43.63 / $173.27 / $285.45
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$41.86 / $77.41 / $116.12
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$85.08 / $85.08 / $85.08
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$48.34 / $113.73 / $251.28
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$52.23 / $128.78 / $700.88
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$110.25 / $212.79 / $3,402.52
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$716.00 / $1,535.00 / $2,175.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$103.54 / $159.85 / $289.58