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Maine rates for HCPCS 50740

Ureteropyelostomy, anastomosis of ureter and renal pelvis

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,230.27 / $1,548.82 / $2,691.53
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$12,302.69 / $13,182.57 / $17,782.79
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,148.15 / $1,862.09 / $2,511.89
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,258.93 / $1,659.59 / $2,691.53
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,412.54 / $1,737.80 / $2,398.83
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,230.27 / $1,659.59 / $3,467.37
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,202.26 / $1,698.24 / $2,511.89