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Idaho rates for HCPCS 50694

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; new access, without separate nephrostomy catheter

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,884.03 / $4,466.84 / $5,495.41
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,819.70 / $3,548.13 / $9,120.11
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$338.84 / $1,288.25 / $4,466.84
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,025.60 / $7,762.47 / $11,220.18
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9,332.54 / $16,982.44 / $18,197.01