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Utah 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 $5,888 · 10th–90th $1,905–$10,2330%10%10th90th$5,888Professionalmedian $1,738 · 10th–90th $457–$2,3440%10%10th90th$1,738$500.0$1.0K$2.0K$5.0K$10.0K$20.0K

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
$1,905.46 / $4,570.88 / $8,511.38
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4,897.79 / $6,760.83 / $10,232.93
Regence BlueShield
Facility/Professional
Facility
Modifier
50
Typical Low / Median / Typical High
$7,413.10 / $10,232.93 / $15,488.17
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$457.09 / $1,737.80 / $2,344.23
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,202.26 / $5,128.61 / $8,317.64