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Nebraska 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
$4,083.97 / $8,477.27 / $19,276.96
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9,732.29 / $13,189.77 / $24,760.56
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$312.04 / $1,571.42 / $5,105.63
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$637.42 / $2,334.78 / $3,310.62
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,341.00 / $7,441.00 / $8,816.00