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Montana 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

Facilitymedian $2,239 · 10th–90th $562$6,7610%20%10th90th$2,239$500.0$2.0K$10.0K$50.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$46,773.51 / $75,857.76 / $95,499.26
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$524.81 / $524.81 / $524.81
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$575.44 / $2,238.72 / $2,454.71
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$302.00 / $660.69 / $2,398.83
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,584.89 / $1,584.89 / $7,244.36