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Missouri rates for HCPCS 50920

Closure of ureterocutaneous fistula

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,059.47 / $4,470.00 / $12,154.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$805.86 / $1,001.25 / $1,022.49
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,224.00 / $4,449.00 / $10,043.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$878.07 / $1,067.48 / $1,716.20
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$783.29 / $1,254.92 / $2,292.32
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$719.23 / $1,493.76 / $6,890.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$986.47 / $1,603.06 / $6,562.40
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,185.00 / $3,233.00 / $11,343.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$917.76 / $1,234.26 / $2,404.92