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Indiana rates for HCPCS 50740

Ureteropyelostomy, anastomosis of ureter and renal pelvis

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,116.08 / $1,386.00 / $4,846.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,116.08 / $1,233.28 / $1,573.68
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,800.00 / $11,044.01 / $15,154.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,146.75 / $1,477.80 / $2,039.36
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,191.05 / $1,624.16 / $2,436.23
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,136.91 / $1,407.60 / $1,948.98
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,160.06 / $1,503.65 / $2,490.37
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,917.00 / $5,660.00 / $11,929.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,094.96 / $1,392.24 / $2,285.84