go back

Arkansas rates for HCPCS 50750

Ureterocalycostomy, anastomosis of ureter to renal calyx

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,479.11 / $1,698.24 / $2,454.71
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,071.52 / $1,318.26 / $1,548.82
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$851.14 / $1,819.70 / $2,137.96
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$371.54 / $1,071.52 / $2,570.40
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,023.29 / $1,202.26 / $2,187.76