go back

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
$223.50 / $3,385.17 / $8,294.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$182.61 / $1,425.81 / $2,222.07
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$170.61 / $928.75 / $2,443.46
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$195.97 / $268.66 / $916.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$202.16 / $499.68 / $3,473.63
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,412.47 / $2,017.82 / $2,485.23
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$206.35 / $1,820.70 / $3,236.73
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$403.25 / $2,578.23 / $4,136.00
Sentara
Facility/Professional
Facility
Modifier
Low / Median / High Price
$194.84 / $265.77 / $1,098.00
Sentara
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,578.00 / $2,314.40 / $4,491.31
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$296.00 / $1,045.00 / $2,364.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,575.60 / $2,532.37 / $4,118.78