go back

Maryland 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
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,745.52 / $1,745.52 / $1,745.52
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,334.38 / $1,744.62 / $3,116.19