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Arkansas rates for HCPCS 50750

Ureterocalycostomy, anastomosis of ureter to renal calyx

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,277.00 / $1,688.00 / $3,109.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,061.05 / $1,561.99 / $1,706.30
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,159.33 / $1,534.42 / $1,534.42
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,335.00 / $1,826.79 / $2,161.37
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$375.00 / $1,056.00 / $2,558.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,055.43 / $1,259.86 / $2,225.02