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Indiana 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
$295.12 / $2,344.23 / $11,220.18
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,456.54 / $14,454.40 / $19,498.45
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$251.19 / $263.03 / $295.12
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$275.42 / $1,148.15 / $1,905.46
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,884.03 / $7,762.47 / $10,964.78