go back

Michigan rates for HCPCS 50715

Ureterolysis W/Worpsg Ureter Retroperit Fibrosis

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,543.73 / $4,933.00 / $4,933.00
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,746.35 / $6,707.73 / $9,137.77
BCBS
Facility/Professional
Facility
Modifier
50
Low / Median / High Price
$3,117.63 / $5,154.05 / $6,195.65
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,219.47 / $4,933.00 / $4,933.00
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,906.00 / $4,645.00 / $6,327.00