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Minnesota 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
$251.19 / $1,148.15 / $1,148.15
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,570.88 / $8,128.31 / $15,848.93
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,951.21 / $4,168.69 / $10,000.00
Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,235.94 / $3,981.07 / $7,762.47
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$354.81 / $1,621.81 / $8,912.51
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,584.89 / $6,760.83 / $10,715.19