go back

New Hampshire 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
$199.53 / $1,819.70 / $9,772.37
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$47.86 / $117.49 / $218.78
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$64.57 / $128.82 / $275.42
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$64.57 / $141.25 / $371.54
Harvard Pilgrim
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,388.44 / $3,388.44 / $7,413.10
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$56.23 / $144.54 / $309.03
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,388.44 / $3,388.44 / $7,413.10
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$57.54 / $147.91 / $323.59
Well Sense
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.00 / $100.00 / $100.00