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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
$467.74 / $2,137.96 / $4,073.80
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$47.86 / $114.82 / $190.55
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$109.65 / $151.36 / $1,621.81
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$61.66 / $117.49 / $257.04
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$47.86 / $47.86 / $123.03
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$51.29 / $107.15 / $263.03
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$54.95 / $4,365.16 / $4,365.16
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,041.74 / $2,041.74 / $3,548.13
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$295.12 / $812.83 / $2,511.89
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$51.29 / $109.65 / $269.15