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Pennsylvania 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
$912.01 / $4,786.30 / $8,511.38
Capital Blue Cross
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,456.54 / $7,585.78 / $57,543.99
Highmark BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,570.40 / $7,244.36 / $22,908.68
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$912.01 / $3,801.89 / $8,317.64
Oscar Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$251.19 / $251.19 / $2,238.72
UPMC Health Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$194.98 / $691.83 / $1,122.02
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,137.96 / $3,981.07 / $10,964.78