go back

New Hampshire rates for HCPCS 50750

Ureterocalycostomy Anast Ureter Renal Calyx

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.00 / $4,686.63 / $9,859.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,183.35 / $1,666.30 / $4,686.63
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,669.00 / $9,734.34 / $16,970.79
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,396.37 / $2,179.71 / $3,292.92
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,461.59 / $2,361.62 / $3,772.36
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,277.16 / $2,533.63 / $4,207.09
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7,448.00 / $7,448.00 / $7,448.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,540.11 / $2,025.48 / $3,773.75
Well Sense
Facility/Professional
Professional
Modifier
Low / Median / High Price
$902.39 / $992.63 / $1,263.34