go back

Utah 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
$2,238.72 / $3,162.28 / $4,570.88
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$177.83 / $1,659.59 / $2,818.38
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$218.78 / $1,318.26 / $3,235.94
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.36 / $33.11 / $1,288.25
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$251.19 / $478.63 / $3,630.78
Select Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$190.55 / $1,659.59 / $3,715.35
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$239.88 / $2,344.23 / $3,388.44
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,071.52 / $4,466.84 / $5,128.61
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$177.83 / $1,445.44 / $3,090.30