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Indiana rates for HCPCS 50688

Change of ureterostomy tube or externally accessible ureteral stent via ileal conduit

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$72.23 / $1,193.16 / $5,634.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$72.23 / $76.77 / $101.85
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,682.00 / $3,840.00 / $7,747.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$80.31 / $100.40 / $142.56
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$72.70 / $92.66 / $106.92
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$71.28 / $81.97 / $106.92
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,286.40 / $1,286.40 / $1,286.40
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$79.45 / $106.81 / $172.36
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,400.00 / $3,870.00 / $5,490.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$68.70 / $93.66 / $212.62