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Vermont rates for HCPCS 50750

Ureterocalycostomy, anastomosis of ureter to renal calyx

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,558.47 / $1,558.47 / $6,064.54
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$995.28 / $1,899.73 / $4,063.02
MVP Health Care
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,207.71 / $1,901.61 / $4,063.02
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,477.78 / $1,635.59 / $4,986.89