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Washington 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 $3,162 · 10th–90th $631–$16,2180%5%10th90th$3,162$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
$676.08 / $3,630.78 / $18,620.87
Asuris Northwest Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$6,606.93 / $9,332.54 / $19,054.61
Asuris Northwest Health
Facility/Professional
Facility
Modifier
50
Typical Low / Median / Typical High
$10,000.00 / $13,803.84 / $28,183.83
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,344.23 / $2,344.23 / $3,890.45
Kaiser Permanente
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$549.54 / $2,041.74 / $4,466.84
Kaiser Permanente
Facility/Professional
Facility
Modifier
50
Typical Low / Median / Typical High
$8,128.31 / $12,882.50 / $25,118.86
Pacific Source
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,513.56 / $2,511.89 / $2,691.53
Premera BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,819.70 / $1,862.09 / $1,862.09
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$6,456.54 / $9,549.93 / $19,054.61
Regence BlueShield
Facility/Professional
Facility
Modifier
50
Typical Low / Median / Typical High
$9,772.37 / $14,454.40 / $28,183.83
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,235.94 / $10,964.78 / $19,952.62