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Alaska rates for HCPCS 50690

Injection procedure for visualization of ileal conduit and/or ureteropyelography, exclusive of radiologic service

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$39.38 / $4,806.00 / $13,413.92
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$71.56 / $157.22 / $526.92
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$102.42 / $180.59 / $419.78
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$87.44 / $137.10 / $464.55
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$182.91 / $314.82 / $768.08
Premera BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$263.75 / $386.13 / $594.52
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$87.44 / $137.10 / $721.89
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$149.99 / $300.86 / $527.25
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$200.00 / $200.00 / $200.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$182.55 / $277.70 / $439.84