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Kentucky 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
$342.98 / $1,231.68 / $4,598.70
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,830.00 / $8,584.00 / $11,253.00
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$318.04 / $436.52 / $503.56
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$573.71 / $573.71 / $573.71
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$739.00 / $3,828.00 / $8,582.00