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Ohio rates for HCPCS 50740

Ureteropyelostomy, anastomosis of ureter and renal pelvis

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,233.28 / $4,980.00 / $11,627.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,187.89 / $1,233.28 / $2,470.33
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,315.00 / $8,450.20 / $15,206.26
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$917.76 / $1,262.66 / $2,148.98
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,169.13 / $1,402.96 / $1,863.30
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,286.04 / $1,286.04 / $2,279.81
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$21,571.00 / $21,571.00 / $21,571.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$983.80 / $1,626.63 / $2,462.77
Medical Mutual of Ohio
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,072.96 / $1,642.01 / $2,462.69
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$115.97 / $1,228.62 / $1,748.79
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,771.00 / $3,098.00 / $6,792.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,129.81 / $1,578.33 / $2,747.94