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Illinois 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
$512.86 / $2,137.96 / $7,762.47
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,454.71 / $5,128.61 / $7,079.46
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$338.84 / $1,513.56 / $3,630.78
Hally Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.00 / $100.00 / $100.00
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,584.89 / $4,365.16 / $9,332.54