go back

Kentucky 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
$267.36 / $1,060.90 / $8,067.26
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,830.00 / $8,584.00 / $11,253.00
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$247.91 / $340.27 / $392.52
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$447.21 / $447.21 / $447.21
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$739.00 / $3,828.00 / $8,582.00