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Virginia 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
$223.87 / $2,630.27 / $8,317.64
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$177.83 / $1,412.54 / $2,398.83
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$181.97 / $1,412.54 / $2,818.38
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$194.98 / $295.12 / $954.99
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$199.53 / $512.86 / $3,235.94
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$154.88 / $2,089.30 / $2,570.40
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,570.88 / $4,570.88 / $4,570.88
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$181.97 / $1,698.24 / $3,388.44
Sentara
Facility/Professional
Facility
Modifier
Low / Median / High Price
$177.83 / $263.03 / $2,454.71
Sentara
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,288.25 / $2,238.72 / $7,413.10
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$229.09 / $1,202.26 / $2,454.71
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$165.96 / $1,258.93 / $3,311.31