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Connecticut rates for HCPCS 50750

Ureterocalycostomy, anastomosis of ureter to renal calyx

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,054.58 / $6,607.00 / $10,492.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,588.52 / $2,054.58 / $2,921.61
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,021.45 / $11,075.34 / $12,977.57
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,145.11 / $2,376.42 / $2,819.51
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,435.42 / $1,799.84 / $3,630.61
ConnectiCare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,596.25 / $1,896.75 / $1,896.75
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,275.00 / $6,137.00 / $16,193.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,202.14 / $1,913.33 / $3,670.80