go back

Washington 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
$131.83 / $309.03 / $17,782.79
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$67.61 / $112.20 / $288.40
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$223.87 / $223.87 / $223.87
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$79.43 / $141.25 / $316.23
Kaiser Permanente
Facility/Professional
Facility
Modifier
Low / Median / High Price
$89.13 / $151.36 / $263.03
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$83.18 / $151.36 / $263.03
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.36 / $33.11 / $56.23
Pacific Source
Facility/Professional
Facility
Modifier
Low / Median / High Price
$144.54 / $208.93 / $239.88
Premera BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$162.18 / $162.18 / $162.18
Premera BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$104.71 / $173.78 / $302.00
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$112.20 / $165.96 / $263.03
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$416.87 / $660.69 / $6,165.95
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$77.62 / $134.90 / $257.04
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$63.10 / $120.23 / $169.82