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Vermont rates for HCPCS 50920

Closure Ureterocutaneous Fistula

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,187.11 / $1,187.11 / $4,637.97
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$762.38 / $1,459.85 / $3,117.95
MVP Health Care
Facility/Professional
Professional
Modifier
Low / Median / High Price
$916.72 / $1,459.85 / $3,117.95
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,136.93 / $1,250.00 / $3,826.94