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Montana rates for HCPCS 50740

Ureteropyelostomy, anastomosis of ureter and renal pelvis

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,610.72 / $6,309.71 / $6,309.71
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,936.52 / $1,936.52 / $1,936.52
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,260.17 / $1,936.52 / $2,059.69
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$955.32 / $2,123.55 / $2,219.44
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,183.69 / $1,775.71 / $2,561.30
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,521.28 / $1,521.28 / $1,521.28
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,675.54 / $2,103.34 / $3,384.56