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Oklahoma 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
$1,047.13 / $2,630.27 / $6,760.83
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,128.61 / $7,943.28 / $13,182.57
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$302.00 / $1,548.82 / $6,309.57
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,230.27 / $4,265.80 / $8,317.64