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Maine 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
Professional
Modifier
Low / Median / High Price
$181.97 / $512.86 / $2,754.23
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$169.82 / $416.87 / $2,884.03
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$229.09 / $380.19 / $3,467.37
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$199.53 / $1,949.84 / $3,388.44
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$199.53 / $457.09 / $3,467.37
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$229.09 / $1,513.56 / $3,548.13