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Utah 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
$402.72 / $3,294.00 / $7,568.00
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,086.24 / $6,609.94 / $9,632.58
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,155.00 / $6,097.00 / $8,267.00