go back

Montana rates for HCPCS 50690

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

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$66.30 / $97.90 / $324.86
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$64,999.99 / $81,499.99 / $94,999.99
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$108.84 / $108.84 / $186.66
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$108.84 / $219.00 / $422.43
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$74.23 / $118.73 / $188.83
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$78.59 / $156.19 / $219.00
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$92.58 / $149.56 / $264.11
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$148.32 / $176.00 / $197.77