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Alabama rates for HCPCS 50695

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, with separate nephrostomy catheter

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$700.00 / $1,399.00 / $2,529.39
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,926.71 / $4,753.60 / $6,395.11
BCBS
Facility/Professional
Facility
Modifier
50
Low / Median / High Price
$5,890.06 / $7,130.39 / $9,592.66
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$950.00 / $3,129.00 / $5,251.00