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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
$426.58 / $3,630.78 / $9,120.11
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,388.44 / $5,888.44 / $12,302.69
CDPHP
Facility/Professional
Facility
Modifier
Low / Median / High Price
$371.54 / $1,258.93 / $4,073.80
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$34.67 / $446.68 / $50,118.72
Emblem Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$263.03 / $338.84 / $870.96
Highmark BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,630.78 / $3,630.78 / $4,570.88
MVP Health Care
Facility/Professional
Facility
Modifier
Low / Median / High Price
$331.13 / $50,118.72 / $75,857.76
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,398.83 / $5,128.61 / $11,481.54
Univera
Facility/Professional
Facility
Modifier
Low / Median / High Price
$213.80 / $338.84 / $741.31