go back

Minnesota rates for HCPCS 50930

Closure of ureterovisceral fistula (including visceral repair)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,047.13 / $1,047.13 / $1,047.13
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,047.13 / $1,230.27 / $2,041.74
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,265.80 / $8,511.38 / $24,547.09
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,659.59 / $2,454.71 / $3,981.07
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,818.38 / $3,981.07 / $9,332.54
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,187.76 / $3,388.44 / $5,011.87
Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,019.95 / $3,801.89 / $7,413.10
Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,041.74 / $2,818.38 / $4,265.80
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,445.44 / $2,041.74 / $3,467.37
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,318.26 / $2,238.72 / $4,897.79
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,584.89 / $3,467.37 / $8,511.38
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,318.26 / $2,238.72 / $4,265.80