go back

Massachusetts 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
$1,288.25 / $3,090.30 / $5,128.61
AllWays Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$56.23 / $5,011.87 / $9,332.54
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$295.12 / $295.12 / $691.83
Fallon Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$177.83 / $363.08 / $7,079.46
Harvard Pilgrim
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,137.96 / $5,248.07 / $11,220.18
Mass General Brigham
Facility/Professional
Facility
Modifier
Low / Median / High Price
$56.23 / $5,248.07 / $9,332.54
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,041.74 / $5,248.07 / $11,220.18