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North Carolina rates for HCPCS 50750

Ureterocalycostomy, anastomosis of ureter to renal calyx

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,123.42 / $1,615.00 / $7,439.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,123.42 / $1,123.42 / $1,983.33
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,364.17 / $2,024.85 / $2,933.29
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,289.70 / $1,915.89 / $3,095.29
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,123.42 / $1,582.07 / $2,846.42
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,582.07 / $1,582.07 / $2,848.18
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.00 / $1,895.70 / $2,844.90
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,172.00 / $4,086.00 / $7,778.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,131.83 / $1,572.45 / $3,429.75
Wellcare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$55.00 / $8,461.44 / $10,475.20
Wellcare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8,367.68 / $8,367.68 / $9,540.60