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New York 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
$406.64 / $3,646.00 / $9,038.00
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,283.00 / $5,160.00 / $11,809.00
CDPHP
Facility/Professional
Facility
Modifier
Low / Median / High Price
$374.40 / $1,254.00 / $4,050.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$447.21 / $447.21 / $13,296.25
Emblem Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$267.00 / $332.00 / $657.41
Highmark BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,617.24 / $3,617.24 / $4,535.22
MVP Health Care
Facility/Professional
Facility
Modifier
Low / Median / High Price
$447.21 / $555.00 / $13,296.25
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,264.00 / $5,735.00 / $11,176.00
Univera
Facility/Professional
Facility
Modifier
Low / Median / High Price
$337.04 / $337.04 / $800.74