go back

Massachusetts 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
$114.82 / $2,238.72 / $3,801.89
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$50.12 / $117.49 / $275.42
AllWays Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$56.23 / $954.99 / $4,365.16
AllWays Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$52.48 / $138.04 / $851.14
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$58.88 / $58.88 / $138.04
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$53.70 / $128.82 / $331.13
Fallon Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$57.54 / $380.19 / $7,079.46
Fallon Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$83.18 / $165.96 / $302.00
Harvard Pilgrim
Facility/Professional
Facility
Modifier
Low / Median / High Price
$630.96 / $2,041.74 / $3,467.37
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$56.23 / $138.04 / $331.13
Mass General Brigham
Facility/Professional
Facility
Modifier
Low / Median / High Price
$56.23 / $1,000.00 / $4,365.16
Mass General Brigham
Facility/Professional
Professional
Modifier
Low / Median / High Price
$52.48 / $138.04 / $812.83
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$501.19 / $1,862.09 / $2,818.38
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$53.70 / $131.83 / $363.08