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Michigan 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
$256.27 / $1,543.08 / $4,933.00
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,229.39 / $3,106.68 / $4,890.24
BCBS
Facility/Professional
Facility
Modifier
50
Low / Median / High Price
$1,648.08 / $2,373.94 / $3,085.48
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$322.89 / $4,112.00 / $4,933.00
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,296.00 / $7,849.00 / $9,202.00