go back

Idaho rates for HCPCS 50930

Closure of ureterovisceral fistula (including visceral repair)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,466.84 / $5,495.41 / $5,495.41
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,023.29 / $1,445.44 / $2,511.89
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,981.07 / $4,466.84 / $5,623.41
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,819.70 / $2,137.96 / $2,187.76
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,318.26 / $1,737.80 / $2,089.30
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,258.93 / $2,238.72 / $3,548.13
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,096.48 / $1,862.09 / $2,187.76
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.36 / $32.36 / $33.11
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,479.11 / $1,778.28 / $2,089.30
Select Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$912.01 / $912.01 / $2,137.96
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,715.35 / $15,488.17 / $26,302.68
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,096.48 / $1,659.59 / $2,344.23