go back

Indiana rates for HCPCS 50693

Placement of ureteral stent, percutaneous, including diagnostic nephrostogram and/or ureterogram when performed, imaging guidance (eg, ultrasound and/or fluoroscopy), and all associated radiological supervision and interpretation; pre-existing nephrostomy tract

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$189.40 / $1,050.80 / $11,093.00
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$970.00 / $5,790.87 / $8,240.00
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$194.10 / $279.50 / $1,198.88
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,218.40 / $2,218.40 / $2,218.40
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,932.00 / $8,025.00 / $11,038.00