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Arizona rates for HCPCS 50930

Closure of ureterovisceral fistula (including visceral repair)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,671.00 / $3,617.00 / $6,329.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,035.53 / $1,121.53 / $5,795.08
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,763.75 / $6,598.50 / $10,860.55
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$679.31 / $905.74 / $1,132.18
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$989.95 / $1,354.67 / $2,432.16
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,053.56 / $1,480.81 / $4,276.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,023.42 / $1,266.48 / $8,172.88
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,424.00 / $3,269.00 / $14,572.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,012.53 / $1,235.45 / $2,106.52