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Michigan rates for HCPCS 50953

Ureteral endoscopy through established ureterostomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with ureteral catheterization, with or without dilation of ureter

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$412.27 / $2,056.00 / $4,933.00
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,490.25 / $4,074.17 / $5,550.14
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$402.78 / $2,056.00 / $4,933.00
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,527.00 / $4,857.00 / $6,327.00