go back

Washington, DC rates for HCPCS 50750

Ureterocalycostomy, anastomosis of ureter to renal calyx

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,017.00 / $1,614.00 / $7,727.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,217.54 / $1,217.54 / $1,217.54
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,322.96 / $1,325.90 / $1,460.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,185.77 / $1,561.41 / $3,871.92
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,173.42 / $2,566.81 / $2,566.81
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$645.00 / $1,319.00 / $16,382.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,072.81 / $1,676.26 / $2,974.06