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Missouri 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
$1,110.00 / $4,261.00 / $7,996.00
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$821.00 / $1,963.00 / $4,852.00
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$241.64 / $1,108.45 / $3,700.00
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,708.00 / $3,502.00 / $6,854.00