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Texas 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
$732.00 / $2,872.00 / $8,883.00
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,595.94 / $4,769.29 / $9,659.33
Christus
Facility/Professional
Facility
Modifier
Low / Median / High Price
$174.16 / $2,613.51 / $2,613.51
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,376.10 / $2,376.10 / $2,376.10
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$55.00 / $55.00 / $1,742.78
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$196.13 / $746.36 / $1,674.19
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$196.13 / $798.16 / $2,191.63
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,634.00 / $4,345.00 / $10,600.00