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South Dakota rates for HCPCS 50690

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

Facilitymedian $117 · 10th–90th $1–$2,2910%10%20%10th90th$117Professionalmedian $117 · 10th–90th $66–$2340%20%10th90th$117$1.0$5.0$20.0$100.0$500.0$2.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.89 / $109.65 / $4,365.16
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$64.57 / $104.71 / $158.49
Avera
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$69.18 / $81.28 / $141.25
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$147.91 / $204.17 / $346.74
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$93.33 / $158.49 / $295.12
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$95.50 / $194.98 / $1,071.52
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$131.83 / $199.53 / $295.12
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$141.25 / $141.25 / $199.53
Sanford Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$102.33 / $147.91 / $229.09
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$812.83 / $812.83 / $812.83
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$89.13 / $151.36 / $275.42
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$134.90 / $165.96 / $275.42