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Tennessee 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
$136.38 / $2,133.00 / $7,602.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$48.76 / $113.20 / $165.08
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$108.00 / $148.00 / $1,676.00
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$58.91 / $114.70 / $266.16
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$47.33 / $85.08 / $122.75
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$51.85 / $108.68 / $275.38
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$55.00 / $347.28 / $700.88
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,002.43 / $2,020.93 / $3,514.80
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$296.00 / $814.00 / $2,495.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$109.69 / $178.85 / $334.98