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Louisiana 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
$422.35 / $1,743.00 / $3,945.00
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,370.95 / $6,397.51 / $10,442.62
Christus
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,638.80 / $2,638.80 / $2,638.80
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$882.00 / $3,238.00 / $8,257.00