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Ohio 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 $4,169 · 10th–90th $891–$10,9650%5%10th90th$4,169$100.0$500.0$2.0K$10.0K

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
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$645.65 / $4,168.69 / $10,964.78
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,698.24 / $3,548.13 / $15,135.61
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$316.23 / $338.84 / $380.19
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$288.40 / $549.54 / $21,379.62
Medical Mutual of Ohio
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$21,379.62 / $21,379.62 / $21,379.62
SummaCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$100.00 / $100.00 / $4,365.16
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,630.27 / $5,754.40 / $9,332.54