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Tennessee rates for HCPCS 50920

Closure of ureterocutaneous fistula

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,821.00 / $2,678.00 / $7,602.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$850.13 / $1,083.50 / $1,175.18
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,417.00 / $2,344.00 / $4,235.00
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$826.68 / $1,127.30 / $1,954.70
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$851.40 / $1,228.97 / $1,937.59
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$55.00 / $7,038.29 / $7,192.85
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$6,420.96 / $6,562.40 / $7,330.05
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,200.00 / $2,665.00 / $4,918.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$853.52 / $1,260.29 / $2,080.54