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Massachusetts rates for HCPCS 50705

Ureteral embolization or occlusion, including imaging guidance (eg, ultrasound and/or fluoroscopy) and all associated radiological supervision and interpretation (List separately in addition to code for primary procedure)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,000.00 / $2,238.72 / $3,801.89
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$177.83 / $1,412.54 / $3,467.37
AllWays Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$56.23 / $1,000.00 / $4,168.69
AllWays Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$181.97 / $1,479.11 / $5,248.07
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$194.98 / $194.98 / $457.09
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$234.42 / $1,000.00 / $5,495.41
Fallon Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$158.49 / $257.04 / $7,079.46
Fallon Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,148.15 / $2,089.30 / $3,235.94
Harvard Pilgrim
Facility/Professional
Facility
Modifier
Low / Median / High Price
$630.96 / $2,041.74 / $3,467.37
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$194.98 / $1,202.26 / $4,466.84
Mass General Brigham
Facility/Professional
Facility
Modifier
Low / Median / High Price
$56.23 / $1,023.29 / $4,168.69
Mass General Brigham
Facility/Professional
Professional
Modifier
Low / Median / High Price
$181.97 / $1,479.11 / $5,248.07
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$630.96 / $1,862.09 / $2,818.38
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$223.87 / $794.33 / $4,570.88