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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
$269.15 / $4,073.80 / $4,897.79
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,011.87 / $6,606.93 / $10,471.29
BCBS
Facility/Professional
Facility
Modifier
50
Low / Median / High Price
$2,884.03 / $4,570.88 / $6,760.83
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$323.59 / $4,073.80 / $4,897.79
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,691.53 / $5,888.44 / $10,000.00