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X-Ray Study Through An Existing Ureteral Tube

Maryland rates for HCPCS 50684

An X-ray imaging study of the ureter, the tube connecting the kidney to the bladder, performed by injecting contrast dye through a tube or catheter that is already in place in the ureter rather than a tube placed directly into the kidney. It is used to check for blockage, leakage, or narrowing after the tube has been placed. This differs from an initial placement of the tube itself, since the tube is already there.

Facilitymedian $126 · 10th–90th $43$5130%10%10th90th$126Professionalmedian $115 · 10th–90th $48$2690%5%10%10th90th$115$50.0$100.0$200.0$500.0$1.0K$2.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Setting
Professional
Modifier
Global
Typical Low
$47.86
Median
$117.49
Typical High
$275.42
CareFirst
Setting
Professional
Modifier
Global
Typical Low
$50.12
Median
$51.29
Typical High
$60.26
Cigna
Setting
Facility
Modifier
Global
Typical Low
$42.66
Median
$42.66
Typical High
$85.11
Cigna
Setting
Professional
Modifier
Global
Typical Low
$48.98
Median
$112.20
Typical High
$251.19
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$95.50
Median
$151.36
Typical High
$204.17
United
Setting
Facility
Modifier
Global
Typical Low
$97.72
Median
$128.82
Typical High
$512.86
United
Setting
Professional
Modifier
Global
Typical Low
$47.86
Median
$112.20
Typical High
$269.15
Wellpoint
Setting
Professional
Modifier
Global
Typical Low
$104.71
Median
$138.04
Typical High
$199.53